Provider Demographics
NPI:1558305060
Name:GRUBER, GARY (DC)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:GRUBER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7019 HARPS MILL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-3248
Mailing Address - Country:US
Mailing Address - Phone:919-850-1300
Mailing Address - Fax:919-850-0012
Practice Address - Street 1:7019 HARPS MILL RD STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3248
Practice Address - Country:US
Practice Address - Phone:919-850-1300
Practice Address - Fax:919-850-0012
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0820UOtherBCBS PROVIDER ID
NC619120OtherACN PROVIDER #
NC2394OtherCHIROPRACTIC LICENSE #