Grossman, Michael Robert

Grossman, Michael Robert is an individual health care provider with primary practice located at 965 Shamrock Ln , Corry PA 16407-1196. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Grossman, Michael Robert can be contacted via phone (814) 664-4641.

Contact Information

Primary practice address
965 Shamrock Ln Corry PA 16407-1196
Phone: (814) 664-4641
Fax: (814) 664-8799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 051467 Georgia
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X OS010419L Pennsylvania

Profile Details

NPI number 1710929708
LBN Legal business name Grossman, Michael Robert
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 12th, 2006
Last updated Dec 19th, 2023 - about last year

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 1710929708 NPPES
Georgia MEDICAID 204624381C

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