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Individual
ROBERT E GROSSMAN
Active
Individual
ROBERT E GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3459
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0553917
—
IA
01
—
10772
BLUE CROSS BLUE SHIELD OF
ND
01
—
123993
WORKER'S COMP
ND
05
—
12563
—
ND
01
—
25972
SIOUX VALLEY
—
05
—
3018140
—
WA
05
—
45034068812
—
NE
05
—
7776150
—
SD
Enumeration date
10/04/2006
Last updated
07/08/2007
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