Provider Demographics
NPI:1922136449
Name:GRINER, WINSTON HENRY SR (MD)
Entity Type:Individual
Prefix:
First Name:WINSTON
Middle Name:HENRY
Last Name:GRINER
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5722 HICKORY PLZ STE B4
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-8573
Mailing Address - Country:US
Mailing Address - Phone:615-429-6420
Mailing Address - Fax:615-730-5036
Practice Address - Street 1:5722 HICKORY PLZ STE B4
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-8573
Practice Address - Country:US
Practice Address - Phone:615-429-6420
Practice Address - Fax:615-730-5036
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000012084207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNBO3378Medicare UPIN