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General NPI Number Information
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NPI Number | 1487514394
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Entity Type | Organization
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Legal Business Name | GRIMA DERMATOLOGY AND SURGERY INC
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 95-390 KUAHELANI AVE STE J-1
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City | MILILANI
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State | HI
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Zip | 96789-1192
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Country | US
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Telephone | 808-909-3252
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Fax | 808-909-3894
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Provider Business Mailing Address
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Address Line | 95-390 KUAHELANI AVE STE J-1
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City | MILILANI
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State | HI
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Zip | 96789-1192
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Country | US
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Telephone | 808-909-3252
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Fax | 808-909-3894
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | SUZANNA LEE LEWIS GRIMA
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Credential | MD
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Telephone | 808-909-3252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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