Provider Demographics
NPI:1285039446
Name:GRUBMAN, RONALD (PA)
Entity Type:Individual
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First Name:RONALD
Middle Name:
Last Name:GRUBMAN
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:5429 LBJ FWY
Mailing Address - Street 2:STE 850
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-2607
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 W GRAND AVE
Practice Address - Street 2:STE 90
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-3275
Practice Address - Country:US
Practice Address - Phone:256-459-4987
Practice Address - Fax:256-459-4980
Is Sole Proprietor?:No
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical