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Individual
MICHAEL D GRIMES
Active
Individual
MICHAEL D GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-25925
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719199
MEDICARE
—
05
—
100289990D
—
KS
Enumeration date
04/25/2006
Last updated
05/08/2014
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