Individual
DEANNA MARIE GRUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
350 LANGDON ST, SOMERSET, KY 42503-2786
(606) 678-8155
(606) 678-7548
Mailing address
350 LANGDON ST, SOMERSET, KY 42503-2786
(606) 678-8155
(606) 678-7548
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
46057
KY
208000000X
Pediatrics Physician
LL32744
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100253060
—
KY
Enumeration date
06/03/2010
Last updated
06/03/2014
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