Healthcare Provider Details

I. General information

NPI: 1154415974
Provider Name (Legal Business Name): FRANCIS C GRUMBINE MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6569 N CHARLES ST SUITE 711
BALTIMORE MD
21204
US

IV. Provider business mailing address

6569 N CHARLES ST SUITE 711
BALTIMORE MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-2765
  • Fax: 410-828-0830
Mailing address:
  • Phone: 443-849-2765
  • Fax: 410-828-0830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberD20637
License Number State

VIII. Authorized Official

Name: DR. FRANCIS C GRUMBINE
Title or Position: PRESIDENT OF CORPORATION
Credential: MD
Phone: 443-849-2765