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NPI Code Detail

MEDICARE: BRIAN SCOTT GRUBER MD

MEDICARE: BRIAN SCOTT GRUBER MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0127XTrauma Surgery Physician35076861OH
22086S0102XSurgical Critical Care Physician35.076861OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2H149640OTHEROHMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518072784
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN SCOTT GRUBER MD
Provider Business Mailing Address
First Line : 1001 COVINGTON ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44510-1617
Country : US
Telephone Number : 330-480-3237
Fax Number : 330-480-3970
Provider Business Practice Location Address
First Line : 1001 COVINGTON ST
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44510-1617
Country : US
Telephone Number : 330-480-3237
Fax Number : 330-480-3970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 03/12/2020

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Directions to “ BRIAN SCOTT GRUBER MD” Practice Location

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