Provider Demographics
NPI:1023008646
Name:GRIMES, JAMIE BROOME (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:BROOME
Last Name:GRIMES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8991 WISCONSING AVE
Mailing Address - Street 2:AMERICA BLDG ROOM 6075
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889
Mailing Address - Country:US
Mailing Address - Phone:301-295-3477
Mailing Address - Fax:
Practice Address - Street 1:BROOOKE ARMY MEDICAL CENTER
Practice Address - Street 2:MCHE-QD/CREDENTIALS, 3851 ROGER BROOKE DRIVE
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-6200
Practice Address - Country:US
Practice Address - Phone:210-916-2460
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010486762084P0800X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry