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General NPI Number Information
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NPI Number | 1619944758
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Entity Type | Individual
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Provider Name | KARL K. GRUBER MD
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 9330 MEDICAL PLAZA DR
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City | N CHARLESTON
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State | SC
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Zip | 29406-9104
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Country | US
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Telephone | 843-797-4179
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Fax | 843-797-4296
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Provider Business Mailing Address
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Address Line | PO BOX 49009
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City | GREENWOOD
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State | SC
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Zip | 29649-0001
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Country | US
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Telephone | 864-223-3070
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Fax | 864-223-1396
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 17430
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License Number State | SC
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