Provider Demographics
NPI:1417074865
Name:GRAUL, ELIZABETH A (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:GRAUL
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 1:3970 S 700 E STE 14
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84107-2585
Mailing Address - Country:US
Mailing Address - Phone:385-257-6284
Mailing Address - Fax:801-281-9681
Practice Address - Street 1:3970 S 700 E STE 14
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2585
Practice Address - Country:US
Practice Address - Phone:385-257-6284
Practice Address - Fax:801-281-9681
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2751391-1205207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology