Grossman, Thomas W

Grossman, Thomas W is an individual health care provider with primary practice located at 608 W Brown St , Waupun WI 53963-1702. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Grossman, Thomas W can be contacted via phone (920) 324-6802.

Contact Information

Primary practice address
608 W Brown St Waupun WI 53963-1702
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 36420 Wisconsin

Profile Details

NPI number 1699749689
LBN Legal business name Grossman, Thomas W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Feb 17th, 2016 - about 9 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 1699749689 NPPES
Wisconsin MEDICAID 32523000

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