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Individual
DR. JASON P. GROSS
Active
Individual
DR. JASON P. GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
4301077983
MI
207W00000X
Ophthalmology Physician
Primary
MD153855
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104967123
—
MI
05
—
104983299
—
MI
01
—
180H27019
BCBS OF MICHIGAN
MI
01
—
382155439
COMMERCIAL INSURANCE
MI
05
—
500687131
—
OR
01
—
P00390624
PALMETTO GBA
MI
Enumeration date
09/22/2005
Last updated
12/30/2018
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