Gross, Jeffrey Glenn

Gross, Jeffrey Glenn is an individual health care provider with primary practice located at 7620 Trenholm Road Ext , Columbia SC 29223-1718. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Gross, Jeffrey Glenn can be contacted via phone (803) 736-7200.

Contact Information

Primary practice address
7620 Trenholm Road Ext Columbia SC 29223-1718
Fax: (803) 736-2116
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 14505 South Carolina
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 14505 South Carolina

Profile Details

NPI number 1427059351
LBN Legal business name Gross, Jeffrey Glenn
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Aug 4th, 2017 - about 7 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 1427059351 NPPES
South Carolina MEDICAID TL2900

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