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Mr. Mahlon David Grimsley, PA
Medical Physician Assistant in Durham, North Carolina
NPI 1114963691

Mahlon David Grimsley is a Medical Physician Assistant based in Durham, NC and is specialized in Medical. Mahlon David Grimsley practices in Durham, NC and has the professional credentials of PA. The NPI Number for Mahlon David Grimsley is 1114963691 and holds a License No. (North Carolina).

The current practice location address for Mahlon David Grimsley is 1824 Hillandale Rd, Durham, NC and can be reached out via phone at 919-957-7862.

Location: 1824 Hillandale Rd, Durham, NC, 27703-5803
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114963691
Provider Name
Mahlon David Grimsley
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
1824 Hillandale Rd, Durham, NC, 27703-5803
Phone Number
919-957-7862
Fax Number
Provider Enumeration Date
06/21/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1021201 01 NCCPA #
institution
Provider Business Practice Location Address Details
Address
1824 Hillandale Rd
City
Durham
State
North Carolina
Zip
27705-2650
Phone Number
919-957-7862
Fax Number
person
Provider Business Mailing Address Details
Address
1824 Hillandale Rd
City
Durham
State
North Carolina
Zip
27705-2650
Phone Number
919-957-7862
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
()
Definition
Definition to come...
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