Basic Information
| Provider Information | |||||||||
| NPI: | 1679026561 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRUCA | ||||||||
| FirstName: | MAREK | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2900 LAMB CIR | ||||||||
| Address2: | |||||||||
| City: | CHRISTIANSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 240736344 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407312000 | ||||||||
| FaxNumber: | 5407312659 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 LAMB CIR | ||||||||
| Address2: | |||||||||
| City: | CHRISTIANSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 24073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5407312000 | ||||||||
| FaxNumber: | 5407312659 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2016 | ||||||||
| LastUpdateDate: | 07/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101266733 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.