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Organization
CHARLES R GRUBB DO PC
Active
Organization
CHARLES R GRUBB DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYANN KOUKIAS (OFFICE MANAGER)
(908) 454-8787
Entity
Organization
Contact information
Practice address
311 BALTIMORE ST, PHILLIPSBURG, NJ 08865
(908) 454-8787
(908) 454-1192
Mailing address
311 BALTIMORE ST, PHILLIPSBURG, NJ 08865-1627
(908) 454-8787
(908) 454-1192
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB033577
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02292400
CAPITAL BLUE CROSS
PA
Enumeration date
11/01/2006
Last updated
04/26/2019
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