Healthcare Provider Details

I. General information

NPI: 1952821530
Provider Name (Legal Business Name): LAURA ELIZABETH GRIGEREIT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MEDICAL CENTER DR
FAIRMONT MN
56031-4575
US

IV. Provider business mailing address

800 MEDICAL CENTER DR
FAIRMONT MN
56031-4575
US

V. Phone/Fax

Practice location:
  • Phone: 507-238-8100
  • Fax:
Mailing address:
  • Phone: 507-238-8100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301113230
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number74305
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: