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Individual
DR. JEANETTE BURGESS GRUBE
Active
Individual
DR. JEANETTE BURGESS GRUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
13145
HI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
48394
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021863
KAISER COMMERCIAL NUMBER
CO
05
—
41835875
—
CO
Enumeration date
01/26/2006
Last updated
06/02/2021
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