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Individual
DERALD P. GRICE
Active
Individual
DERALD P. GRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0101057941
VA
208VP0000X
Pain Medicine Physician
0101057941
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006802354
FIRST HEALTH
VA
05
—
006802354
—
VA
01
—
147149
SOUTHERN HEALTH
VA
01
—
41886
OPTIMA
VA
01
—
433065
ANTHEM
VA
01
—
6802354
VA PREMIER
VA
01
—
700027226
CIGNA
VA
Enumeration date
02/07/2006
Last updated
08/09/2023
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