Individual
NATHAN LEWIS GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1188 W UNIVERSITY DR, BOISE, ID 83706-3009
(208) 336-8250
(208) 345-9514
Mailing address
1188 W UNIVERSITY DR, BOISE, ID 83706-3009
(208) 336-8250
(208) 345-9514
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
62489
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
M-15091
ID
Other
Enumeration date
04/08/2014
Last updated
01/26/2023
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