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Individual

CALVIN GRUBBS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, FAAFP

Contact information

Practice address
9040A JACKSON AVE, TACOMA, WA 98431-9098
(253) 968-1110
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-1765

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
28217
NE
207Q00000X
Family Medicine Physician
MD37496
SC
207Q00000X
Family Medicine Physician
Primary
MD61021807
WA

Other

Enumeration date
04/01/2013
Last updated
10/06/2021
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