MEDICARE: DR. KIMBERLY DENISE GRIGSBY-SESSOMS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	33919	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	75241	OTHER	NC	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396799334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIMBERLY DENISE GRIGSBY-SESSOMS M.D.

Provider Business Mailing Address
First Line	:	500 BEAMAN ST
Second Line	:
City	:	CLINTON
State	:	NC
Zip	:	28328-2602
Country	:	US
Telephone Number	:	910-290-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 SW RAILROAD ST
Second Line	:
City	:	ROSE HILL
State	:	NC
Zip	:	28458-9200
Country	:	US
Telephone Number	:	910-289-9248
Fax Number	:	910-289-7437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	09/05/2012

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