Provider Demographics
NPI:1861484586
Name:GRIEBEL, STEPHEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:R
Last Name:GRIEBEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:506 ATHENA DR
Mailing Address - Street 2:
Mailing Address - City:DELMONT
Mailing Address - State:PA
Mailing Address - Zip Code:15626-1005
Mailing Address - Country:US
Mailing Address - Phone:724-468-6869
Mailing Address - Fax:724-468-6207
Practice Address - Street 1:81 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2605
Practice Address - Country:US
Practice Address - Phone:814-938-4777
Practice Address - Fax:814-938-1460
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2008-11-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068178L207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA17464790001Medicaid
PAG90250Medicare UPIN
PA5356240001Medicare NSC
PAGR026091Medicare ID - Type Unspecified