Cortez Granados, Samuel Reynaldo

Cortez Granados, Samuel Reynaldo is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Endocrinology And Diabetes, Saint Louis MO 63110-1002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is his primary health care specialty. Cortez Granados, Samuel Reynaldo can be contacted via phone (314) 454-6051.

Contact Information

Primary practice address
1 Childrens Pl Div Ped Endocrinology And Diabetes Saint Louis MO 63110-1002
Phone: (314) 454-6051
Fax: (314) 454-6225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2020019635 Missouri
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 2020019635 Missouri

Profile Details

NPI number 1255872479
LBN Legal business name Cortez Granados, Samuel Reynaldo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2017
Last updated Apr 25th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255872479 NPPES
Missouri MEDICAID 200048695

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