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Individual
MR. PATRICK J GRIMM
Active
Individual
MR. PATRICK J GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
468
MT
363AM0700X
Medical Physician Assistant
468
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154318574
—
ID
05
—
1154318574
—
MT
Enumeration date
09/30/2005
Last updated
11/05/2015
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