Provider Demographics
NPI:1184796682
Name:DAVID S. GRUBBS, M.D., P.A.
Entity type:Organization
Organization Name:DAVID S. GRUBBS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-738-7303
Mailing Address - Street 1:K15 OMEGA DRIVE, SUITE 5
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-738-7303
Mailing Address - Fax:302-738-7308
Practice Address - Street 1:K15 OMEGA DRIVE, SUITE 5
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-738-7303
Practice Address - Fax:302-738-7308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0003022207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE001401196OtherAMERIHEALTH ADMINISTRATOR
DE174289OtherCOVENTRY OF DELAWARE
DE1417360006OtherCIGNA
DE2089779000OtherAMERIHEALTH
DE417709OtherOPTIMUM CHOICE MAMSI
DE5283108OtherNEW JERSEY MEDICAID
DE060069291OtherRAILROAD MEDICARE
DE2089779000OtherINDEPENDENCE BLUE CROSS
DE4203484OtherAETNA
DE1000015374Medicaid
DE2751456OtherAETNA HMO
DE4203484OtherAETNA
DEG00923Medicare ID - Type Unspecified
DE2089779000OtherINDEPENDENCE BLUE CROSS