Provider Demographics
NPI:1407046501
Name:GRIMES, KATHERINE E (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:E
Last Name:GRIMES
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 BEACON ST FL 4
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-4370
Mailing Address - Country:US
Mailing Address - Phone:617-503-8454
Mailing Address - Fax:
Practice Address - Street 1:20 WALL STREET
Practice Address - Street 2:HVMA ATRIUS HEALTH
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4758
Practice Address - Country:US
Practice Address - Phone:781-221-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA474942084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry