Individual
DR. LARRY DOUGLAS GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
130 N WASHINGTON ST, SUMTER, SC 29150-4920
(803) 774-8888
(803) 778-6376
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8614
(843) 777-2019
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
15990
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MPA270
—
SC
Enumeration date
07/03/2006
Last updated
08/20/2020
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