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GRANUM, MICHAEL JAMES       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 940 E. 3RD ST., #101
CASPER WY 82601
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 11956
Dated: 9/11/1978
Expires: 6/30/1989
License Type: Medical Doctor
Specialty: Pediatrics
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of ND Sch Of Med and Hlth Sci, Grand Forks Nd 58201
Graduated: 5 / 1977
CME Year:
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PEDIATRICS
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
940 E. 3RD ST., #101
CASPER WY 82601

Phone #:
Fax #:

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