Healthcare Provider Details

I. General information

NPI: 1275108375
Provider Name (Legal Business Name): JACOB GILBERT GRUBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 PROSPECT ST
MILFORD MA
01757-3003
US

IV. Provider business mailing address

211 PARK ST
ATTLEBORO MA
02703-3137
US

V. Phone/Fax

Practice location:
  • Phone: 508-422-2240
  • Fax:
Mailing address:
  • Phone: 508-222-5200
  • Fax: 508-236-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1022414
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: