Provider Demographics
NPI:1477518165
Name:GRUSPE, ARNOLD FELIPE (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:FELIPE
Last Name:GRUSPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:474 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-0909
Mailing Address - Country:US
Mailing Address - Phone:304-269-6666
Mailing Address - Fax:304-269-6665
Practice Address - Street 1:474 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-0909
Practice Address - Country:US
Practice Address - Phone:304-269-6666
Practice Address - Fax:304-269-6665
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV09670208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0130614000Medicaid
WV0130614000Medicaid
D49214Medicare UPIN