# DR. JASON P. GROSS

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

## Provider details

- **NPI number:** 1609862846
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 4301077983 | MI | — |
| 207W00000X | Ophthalmology Physician | MD153855 | OR | Yes |

## Other

- **Enumeration date:** 09/22/2005
- **Last updated:** 12/30/2018

## 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 |