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Individual
MICHAEL B GROSS
Active
Individual
MICHAEL B GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
H8091
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118934201
—
TX
05
—
118934202
—
TX
01
—
340016189
RRMCR
TX
01
—
340016194
RRMCR OTHER
TX
01
—
80403X
BCBS PROVIDER ID
—
Enumeration date
05/27/2006
Last updated
01/31/2017
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