Provider Demographics
NPI:1376635177
Name:GRINSTEAD, JULIE G (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:G
Last Name:GRINSTEAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE B321
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6703
Mailing Address - Country:US
Mailing Address - Phone:251-633-0793
Mailing Address - Fax:251-633-0736
Practice Address - Street 1:6701 AIRPORT BLVD STE B321
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-6703
Practice Address - Country:US
Practice Address - Phone:251-633-0793
Practice Address - Fax:251-633-0736
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00025248207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-16024OtherBCBS-AL NUMBER
AL009922945Medicaid
AL009922945Medicaid
AL515-16024OtherBCBS-AL NUMBER