Individual
EDMUNDO MANUEL GRAB
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 12TH AVE, BUILDING A, ALTOONA, PA 16601-3100
(814) 944-7097
(814) 944-5557
Mailing address
1701 12TH AVE, BUILDING A, ALTOONA, PA 16601-3100
(814) 944-7097
(814) 944-5557
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
MD016323E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006902800003
—
PA
Enumeration date
08/03/2005
Last updated
07/08/2007
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