Mark W Grimm, MD is a
Otolaryngology physician based in Fenton, Missouri. Mark W Grimm is licensed to practice in Missouri (license number 2001018662) and his current practice location is 1011 Bowles Ave, Suite 405, Fenton, Missouri. He can be reached at his office (for appointments etc.) via phone at
(314) 965-9184.
NPI number for Mark W Grimm is 1942271689 and his current mailing address is Po Box 790379, Saint Louis, Missouri. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1942271689.
Physician's Profile
| Full Name | Mark W Grimm |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Location | 1011 Bowles Ave, Fenton, Missouri |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1942271689
- Provider Enumeration Date: 01/31/2006
- Last Update Date: 05/19/2011
Medical Identifiers
Medical identifiers for Mark W Grimm such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942271689 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Y00000X | Otolaryngology | 2001018662 (Missouri) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mark W Grimm is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mark W Grimm, MD
Po Box 790379,
Saint Louis, MO 63179-0379
Ph: (314) 965-9184 | Mark W Grimm, MD
1011 Bowles Ave, Suite 405,
Fenton, MO 63026-2395
Ph: (314) 965-9184 |
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