MEDICARE: MR. SHAD T GRUBBS MD

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	38915	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00073483	OTHER	CO	RAILROAD MEDICARE

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	:	1982651899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SHAD T GRUBBS MD

Provider Business Mailing Address
First Line	:	1606 PRAIRIE CENTER PARKWAY
Second Line	:	SUITE #310
City	:	BRIGHTON
State	:	CO
Zip	:	80601
Country	:	US
Telephone Number	:	303-659-5800
Fax Number	:	303-659-5156

Provider Business Practice Location Address
First Line	:	1606 PRAIRIE CENTER PARKWAY
Second Line	:	SUITE #310
City	:	BRIGHTON
State	:	CO
Zip	:	80601
Country	:	US
Telephone Number	:	303-659-5800
Fax Number	:	303-659-5156

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	04/25/2011

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Directions to “ MR. SHAD T GRUBBS MD” Practice Location

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