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Individual
SCOTT T GRODMAN
Active
Individual
SCOTT T GRODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
5901001478
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H22790
BC DME
MI
05
—
2948227
—
MI
01
—
48-0H244260
BC
MI
01
—
4858213180
BC
MI
Enumeration date
09/08/2005
Last updated
05/10/2017
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