Individual
EDWARD ALLAN GRIMBALL
Active
Individual
EDWARD ALLAN GRIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
29702
KY
207R00000X
Internal Medicine Physician
Primary
29702
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000075035
ANTHEM
KY
01
—
04-906
UNITED HEALTHCARE
KY
01
—
1101698818
MEDICARE RAILROAD
KY
01
—
1181211
CHA
KY
01
—
37J8
ANTHEM
KY
01
—
5169150
CCN/AETNA
KY
01
—
611350780
FEDERAL TAX ID
KY
05
—
64297021
—
KY
Enumeration date
11/03/2005
Last updated
04/09/2015
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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