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Individual

TERRENCE E GRIMM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2401
(701) 234-7378
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2401
(701) 234-7378

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
29858
MN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
5243
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10444
NDBC
01
1119587
MEDICA
05
16654
ND
01
89611
PREFERRED ONE
05
924507300
MN
01
92456GR
MNBC
01
HP10513
HEALTHPARTNERS
Enumeration date
06/28/2006
Last updated
01/19/2012
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