Individual
DR. GWEN M GRIMSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5779 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
42236
AZ
2088P0231X
Pediatric Urology Physician
42236
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
450344
—
AZ
Enumeration date
05/27/2008
Last updated
02/06/2025
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