# DARRYL S GROSS MD PC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICAL WEIGHT LOSS & FAMILY PRACTICE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285814491
- **Authorized official:** MRS. VANESSA DENISE GROSS (OFFICE ADMINISTRATOR)
- **Authorized official phone:** (770) 860-8860

## Contact information

- **Practice address:** 2280 SALEM RD SE, SUITE 102, CONYERS, GA 30013-2003
- **Practice address phone:** (770) 860-8860
- **Practice address fax:** (770) 860-8890
- **Mailing address:** 2280 SALEM RD SE, SUITE 102, CONYERS, GA 30013-2003
- **Mailing address phone:** (770) 860-8860
- **Mailing address fax:** (770) 860-8890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 01/10/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | GRP6702 | MEDICARE GROUP NUMBER ASS | GA |