Individual
DR. LAURA KATHERINE GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Mailing address
300 LONGWOOD AVE, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
00044897
WA
208000000X
Pediatrics Physician
Primary
255759
MA
208000000X
Pediatrics Physician
M5194
TX
2080A0000X
Pediatric Adolescent Medicine Physician
MA5194
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245210780
—
WA
05
—
185682507
—
TX
01
—
185682508
CSHCN
TX
05
—
185682509
—
TX
01
—
8V3105
BCBS
TX
Enumeration date
01/19/2006
Last updated
06/15/2022
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