Individual
DR. SAMUEL OLIVER GRIMM III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10521 ROSEHAVEN ST, SUITE LL 100, FAIRFAX, VA 22030-2837
(703) 281-5000
(703) 255-0765
Mailing address
8110 MAPLE LAWN BLVD STE 235, FULTON, MD 20759-2694
(301) 340-8339
(301) 340-9027
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101043338
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
V006215653
—
VA
Enumeration date
07/07/2006
Last updated
05/13/2021
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