Provider Demographics
NPI:1649299256
Name:GRUBER, DAVID M (MD)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:M
Last Name:GRUBER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:138 HAVERHILL ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1509
Mailing Address - Country:US
Mailing Address - Phone:978-475-4322
Mailing Address - Fax:978-474-4537
Practice Address - Street 1:138 HAVERHILL ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-1509
Practice Address - Country:US
Practice Address - Phone:978-475-4322
Practice Address - Fax:978-474-4537
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA207782207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA401223OtherHARVARD
MA207782OtherTUFTS
MAJ24588OtherBLUE CROSS/BLUE SHIELD
MA55400OtherFALLON
MA0300329OtherUNITED HEALTHCARE
MA2747691OtherAETNA
MA0300329OtherUNITED HEALTHCARE