Provider Demographics
NPI:1912032129
Name:GRUBBS, DAVID SCOTT (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:GRUBBS
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 1:131 COMMONWEALTH DR
Mailing Address - Street 2:WORKWELL OCCUPATIONAL HEALTH
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4883
Mailing Address - Country:US
Mailing Address - Phone:864-675-4600
Mailing Address - Fax:864-675-4604
Practice Address - Street 1:131 COMMONWEALTH DR
Practice Address - Street 2:WORKWELL OCCUPATIONAL HEALTH
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4883
Practice Address - Country:US
Practice Address - Phone:864-675-4600
Practice Address - Fax:864-675-4604
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10319207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCA72552Medicare UPIN