Organization
GRUBE RETINA CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS JAMES GRUBE M.D. (PRESIDENT)
(701) 214-7879
Entity
Organization
Contact information
Practice address
107 3RD AVE NW, MANDAN, ND 58554-3129
(701) 751-2131
(701) 751-2133
Mailing address
107 3RD AVE NW, MANDAN, ND 58554-3129
(701) 751-2131
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9201
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659328516
—
ND
Enumeration date
06/21/2010
Last updated
04/27/2020
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