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Individual

JAMES DONALD GRIST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
444 NC HWY 108, RUTHERFORDTON, NC 28139-2406
(828) 286-2302
(828) 287-4320
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10475
AL
207Q00000X
Family Medicine Physician
7509
SC
207Q00000X
Family Medicine Physician
Primary
9601785
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8910194
NC
01
P00976732
RAILROAD MEDICARE
NC
Enumeration date
06/13/2007
Last updated
02/28/2013
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