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Individual

AMY GRUBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(216) 844-7700
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35082636
OH
208000000X
Pediatrics Physician
Primary
35082636
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000221210
UNISON
OH
01
000000526047
ANTHEM
OH
05
1015709030001
PA
01
2421632
BCMH
OH
05
2421632
OH
01
363590
WELLCARE
OH
01
745909
BUCKEYE
OH
01
7789768
AETNA
OH
Enumeration date
06/13/2006
Last updated
12/21/2020
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