Individual
MR. STEPHEN D. GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 SEA MOUNTAIN HIGWAY, SUITE C, LITTLE RIVER, SC 29566
(843) 399-4848
(910) 653-2346
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22475
NC
207Q00000X
Family Medicine Physician
Primary
7841
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0363
CIGNA MEDICARE
NC
01
—
2315069
CIGNA MEDICARE
NC
01
—
561243962
BCBS
SC
01
—
570941629
BCBS
SC
05
—
5950176
—
NC
05
—
5950653
—
NC
05
—
890291H
—
NC
01
—
CA9980
RAILROAD MEDICARE
NC
05
—
E16113
—
SC
Enumeration date
07/12/2005
Last updated
11/02/2022
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