John James Grimes, PH.D.
Individual provider Active NPI Specialist · Dover, MA
NPI 1780705152 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1780705152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- PY 3988 (MA)
- Practice address
- 30 Centre St
Dover, MA 02030-2204 - Phone
- (781) 785-0305
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 3988 | MA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | PY 3988 | MA | Yes |
Addresses
Primary practice location
30 Centre St
Dover, MA 02030-2204
Mailing address
30 Centre St
PO Box 812
Dover, MA 02030-2204
Phone (781) 785-0305
Other providers in Dover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.