David R Grube, M.D.

Individual provider Active NPI Family Medicine Physician · Philomath, OR

NPI 1922058817 · NPPES record last updated Jun 5, 2009

Key facts

NPI
1922058817
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
MD10373 (OR)
Practice address
1219 Applegate
Philomath, OR 97370
Phone
(541) 929-2922
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Philomath Family Medicine, P.C. Past Accepting new patients
The Corvallis Clinic P C Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14349/brand/4/csg/42/fhir/r4

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD10373 OR Yes

Addresses

Primary practice location

1219 Applegate
Philomath, OR 97370

Mailing address

444 NW Elks Dr
Corvallis, OR 97330-3745

Other identifiers

IdentifierTypeStateIssuer
073262MedicaidOR

Other providers in Philomath, OR

All providers in Philomath, OR · Family Medicine Physician in Oregon

Sources for this page

Verify at the official NPI Registry.