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General NPI Number Information
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NPI Number | 1376531335
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Entity Type | Individual
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Provider Name | PETER GRUBEL MD
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 3377 RIVERBEND DR
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City | SPRINGFIELD
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State | OR
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Zip | 97477-8803
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Country | US
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Telephone | 541-222-6389
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Fax | 541-222-6385
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Provider Business Mailing Address
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Address Line | PO BOX 1475
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City | DES MOINES
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State | IA
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Zip | 50305-1475
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Country | US
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Telephone | 515-222-7600
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Fax | 515-222-7601
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME84033
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301113746
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD-44630
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD213472
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License Number State | OR
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