IndividualActive
Adam Grimm, PA
NPI 1407110653 · Physician Assistant · Pewaukee, WI
Provider details
- NPI number
- 1407110653
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 100887-875 (WI)
Practice location
N15w28300 Golf Rd
Pewaukee, WI 53072-4800
Phone: (262) 303-5055
Fax: (262) 303-5057
Mailing address
N15w28300 Golf Rd
Pewaukee, WI 53072-4800
Registry dates
- Enumerated
- 2012-07-02
- Last updated
- 2023-08-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.