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NPI Code Detail

MEDICARE: DANA GRBIC, MD, A PROFESSIONAL MEDICAL CORPORATION

MEDICARE: DANA GRBIC, MD, A PROFESSIONAL MEDICAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD.200378LA

General Provider Information

NPI Number : 1407865496
Entity Type Code : Organization
Provider Name (Legal Business Name) : DANA GRBIC, MD, A PROFESSIONAL MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 3149 AMBASSADOR CAFFERY PKWY
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-7209
Country : US
Telephone Number : 337-261-0734
Fax Number : 337-261-5471
Provider Business Practice Location Address
First Line : 3149 AMBASSADOR CAFFERY PKWY
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-7209
Country : US
Telephone Number : 337-261-0734
Fax Number : 337-261-5471
Authorized Official
Title or Position : PRESIDENT/SECRETARY/TREASURER
Name : DR. DANA GRBIC
Credential : M.D.
Telephone Number : 337-281-0007
Provider Enumeration Date : 08/07/2006
Last Update Date : 10/01/2017

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