Provider Demographics
NPI:1376022921
Name:GRIEBEL, DONNA (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:GRIEBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2129 NEW HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-3047
Mailing Address - Country:US
Mailing Address - Phone:301-537-0842
Mailing Address - Fax:
Practice Address - Street 1:2129 NEW HAMPSHIRE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-3047
Practice Address - Country:US
Practice Address - Phone:301-537-0842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-22926207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine