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General NPI Number Information
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NPI Number | 1780895755
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Entity Type | Individual
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Provider Name | DEVAN GRINER MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 11762 S STATE ST STE 110
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City | DRAPER
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State | UT
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Zip | 84020-7158
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Country | US
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Telephone | 385-218-0587
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Fax | 385-381-4447
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Provider Business Mailing Address
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Address Line | 11762 S STATE ST STE 110
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City | DRAPER
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State | UT
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Zip | 84020-7158
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Country | US
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Telephone | 385-218-0587
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Fax | 385-381-4447
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 374716-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 374716-1205
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | 374716-1205
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License Number State | UT
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