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General NPI Number Information
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NPI Number | 1487070397
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Entity Type | Individual
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Provider Name | PATRICK DAVID GRIMM MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2014
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 1220 W WHEELER PKWY
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City | AUGUSTA
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State | GA
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Zip | 30909-6625
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Country | US
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Telephone | 706-721-3585
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Fax |
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Provider Business Mailing Address
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Address Line | 300 EAST HOSPITAL ROAD
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City | FORT EISENHOWER
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State | GA
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Zip | 30905
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Country | US
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Telephone | 706-787-3275
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 2020-01095
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number | 90738
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 90738
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License Number State | GA
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