| Doctor Name: | DR. ANGELA SMITH GRAB |
| NPI Number: | 1134476880 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 11109 Parkview Plaza Dr Fort Wayne, IN - 468451701 |
| Business Phone Number: | 2602662770 |
| Business Fax Number: | 2606726639 |
| Mailing Address: | 1130 West Michigan Street, Fesler Hall 204 INDIANAPOLIS |
| State: | IN |
| Postal Code: | 46202 |
| Phone Number: | 3172744343 |
| Fax Number: | 3172740256 |
| NPI Enumeration Date: | 08/13/2012 |
| NPI Last Update Date: | 06/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |