IREDELL PHYSICIAN NETWORK LLC NPI 1477805166

NPI Information

  • NPI: 1477805166
  • Provider Name: IREDELL PHYSICIAN NETWORK, LLC
  • Classification: Internal Medicine - 207RH0003X
  • Specialization: Hematology & Oncology
  • Entity Type: Organization
  • Doing Business As: RUBY GRIMM, M.D.
  • Address: 738 BRYANT ST
    STATESVILLE, NC
    ZIP 28677
  • Phone: (704) 873-2219

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NPI Details

IREDELL PHYSICIAN NETWORK, LLC is a hematology and oncology internal medicine in Statesville, NC. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. IREDELL PHYSICIAN NETWORK, LLC NPI is 1477805166. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Ruby Grimm, M.d..

The provider's business location address is:

738 BRYANT ST
STATESVILLE, NC
ZIP 28677-189
Phone: (704) 873-2219
Fax: (704) 873-1379

The provider's authorized official is Kathryn Heles .
The authorized official title is Credentialing and has the following contact phone number (866) 340-0396.

The enumeration date for this NPI number is 10/5/2012 and was last updated on 4/5/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes

What is NPI?

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This page was last updated on: 3/30/2025

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