Individual
JOHN D GRIMME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4001 PRINCE WILLIAM PKWY STE 302, WOODBRIDGE, VA 22192-7667
(703) 494-3309
(703) 321-3300
Mailing address
8001 FORBES PL STE 103, SPRINGFIELD, VA 22151-2205
(814) 426-7319
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
0101255768
VA
2085R0202X
Diagnostic Radiology Physician
25740
WV
2085R0202X
Diagnostic Radiology Physician
Primary
MD25664
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093751224
—
VA
05
—
1093751224
—
WV
05
—
213369
—
OR
05
—
475804801
—
MD
05
—
8425142
—
WA
05
—
MD1459R
—
AK
05
—
MD3449R
—
AK
Enumeration date
06/22/2006
Last updated
06/10/2022
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