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General NPI Number Information
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NPI Number | 1528080777
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Entity Type | Individual
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Provider Name | NICHOLAS ANTHONY GRIMALDI D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 114 GATEWAY CORPORATE BLVD STE 240
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City | COLUMBIA
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State | SC
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Zip | 29203-9785
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Country | US
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Telephone | 803-365-8660
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Fax |
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Provider Business Mailing Address
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Address Line | 509 OLD COMPASS RD
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-8604
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Country | US
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Telephone | 717-586-9936
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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 | D01840
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DO87813
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | DO 1840
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | DO87813
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License Number State | SC
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DO1840
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License Number State | TN
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