Fossum, Gregory T

Fossum, Gregory T is an individual health care provider with primary practice located at 8900 N Kendall Dr , Miami FL 33176-2118. He recently has only one registered license in Allopathic & Osteopathic Physicians / Reproductive Endocrinology, which is considered as his primary health care specialty. Fossum, Gregory T can be contacted via phone (786) 596-1960.

Contact Information

Primary practice address
8900 N Kendall Dr Miami FL 33176-2118
Phone: (786) 596-1960
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Reproductive Endocrinology 207VE0102X MD046162L Pennsylvania

Profile Details

NPI number 1982623658
LBN Legal business name Fossum, Gregory T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982623658 NPPES
Florida Other ME121321 FLORIDA STATE MEDICAL LICENSE
Florida MEDICAID 001272293 FLORIDA STATE MEDICAL LICENSE
Florida MEDICAID 7608209 FLORIDA STATE MEDICAL LICENSE

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