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Individual

DERALD P. GRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
415 RAY C. HUNT DRIVE, SUITE 3100, CHARLOTTESVILLE, VA 22903-7851
(434) 243-3633
(434) 243-1539
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0101057941
VA
208VP0000X
Pain Medicine Physician
0101057941
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
006802354
FIRST HEALTH
VA
05
006802354
VA
01
147149
SOUTHERN HEALTH
VA
01
41886
OPTIMA
VA
01
433065
ANTHEM
VA
01
6802354
VA PREMIER
VA
01
700027226
CIGNA
VA
Enumeration date
02/07/2006
Last updated
08/09/2023
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