# MICHAEL H GRODIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1184670366
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 0102201638 | VA | — |
| 207W00000X | Ophthalmology Physician | 25MB08472300 | NJ | — |
| 207W00000X | Ophthalmology Physician | DO034176 | DC | — |
| 207W00000X | Ophthalmology Physician | H0062012 | MD | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 04/11/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 143192VYZ | MEDICARE | MD |
| 05 | — | 405458000 | — | MD |