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General NPI Number Information
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NPI Number | 1578795290
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Entity Type | Individual
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Provider Name | RICHARD GRINSTEAD DO
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Gender | Male
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Dates
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Enumeration Date | 08/13/2009
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 555 E CHEVES ST DEPT OF
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City | FLORENCE
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State | SC
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Zip | 29506-2617
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Country | US
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Telephone | 843-777-2106
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Fax | 843-777-5109
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Provider Business Mailing Address
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Address Line | 555 E CHEVES ST DEPT OF
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City | FLORENCE
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State | SC
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Zip | 29506-2617
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Country | US
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Telephone | 843-777-2106
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Fax | 843-777-5109
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 298316
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 298316
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 89702
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License Number State | SC
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