Individual
DR. THOMAS J GRUBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 3RD AVE NW, MANDAN, ND 58554-3129
(701) 751-2131
(701) 751-2133
Mailing address
1514 BUCCANEER PL, BISMARCK, ND 58504-8982
(701) 250-6820
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
9201
ND
208600000X
Surgery Physician
9201
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12035
—
ND
Enumeration date
05/27/2006
Last updated
08/18/2010
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