Grossman, Rex Daniel

Grossman, Rex Daniel is an individual health care provider with primary practice located at 1011 W 2Nd St , Bloomington IN 47403-2216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Grossman, Rex Daniel can be contacted via phone (812) 334-1213.

Contact Information

Primary practice address
1011 W 2Nd St Bloomington IN 47403-2216
Phone: (812) 334-1213
Fax: (812) 333-5039
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X IN01027063A Indiana

Profile Details

NPI number 1306828322
LBN Legal business name Grossman, Rex Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Feb 16th, 2012 - about 13 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 1306828322 NPPES
Indiana MEDICAID 100358360A

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