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NPI Code Detail

MEDICARE: MICHAEL ALLAN GRIM PH.D.

MEDICARE: MICHAEL ALLAN GRIM PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist266OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2736017987108OTHEROKDEPT OF REHAB

General Provider Information

NPI Number : 1659361665
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ALLAN GRIM PH.D.
Provider Business Mailing Address
First Line : 834 NW 16TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-6402
Country : US
Telephone Number : 405-270-0501
Fax Number :
Provider Business Practice Location Address
First Line : 921 NE 13TH ST
Second Line : VAMC AUDIOLOGY #126
City : OKLAHOMA CITY
State : OK
Zip : 73104-5007
Country : US
Telephone Number : 405-270-0501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2005
Last Update Date : 04/15/2025

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Directions to “ MICHAEL ALLAN GRIM PH.D.” Practice Location

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