MEDICARE: DR. AMELIA B GRUBER M.D.

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
1	207R00000X	Internal Medicine Physician	35 . 021848	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811027626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMELIA B GRUBER M.D.

Provider Business Mailing Address
First Line	:	4480 CATLIN DR
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-2533
Country	:	US
Telephone Number	:	216-481-2406
Fax Number	:

Provider Business Practice Location Address
First Line	:	4480 CATLIN DR
Second Line	:
City	:	RICHMOND HTS
State	:	OH
Zip	:	44143-2533
Country	:	US
Telephone Number	:	216-481-2406
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/09/2007

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