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Individual

WILLIAM ARCHIE GRIMSLEY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
3500 ARENDELL ST, MOREHEAD CITY, NC 28557
(252) 808-6074
Mailing address
PO BOX 20169, ROANOKE, VA 24018-0506

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
32712
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
220015619
RR MEDICARE
NC
01
37682
BCBS OF NC
NC
05
8937682
NC
Enumeration date
03/25/2006
Last updated
04/30/2020
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