Healthcare Provider Details

I. General information

NPI: 1841225133
Provider Name (Legal Business Name): DANIEL DAVID GRUBER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/06/2020
Certification Date: 10/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

V. Phone/Fax

Practice location:
  • Phone: 301-400-2685
  • Fax:
Mailing address:
  • Phone: 301-400-2685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberMD039970
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA86941
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberD88462
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: