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Individual

MICHAEL DAVID GRUBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M D PC

Contact information

Practice address
106 BLANCA AVE STE 300, ALAMOSA, CO 81101-2340
(719) 589-3658
(719) 589-0997
Mailing address
1970 E 3RD AVE, DURANGO, CO 81301-5056
(970) 247-2214
(970) 247-3277

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9459
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
13911
NM
Enumeration date
06/09/2005
Last updated
01/26/2020
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