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Individual
MR. DOUGLAS L GROSSMANN
Active
Individual
MR. DOUGLAS L GROSSMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001252
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012815
—
IA
01
—
0117548
MEDICA
IA
01
—
10014
SIOUX VALLEY HEALTH PLAN
IA
01
—
238209
MIDLANDS CHOICE
IA
01
—
426038405
CONNECTICUT GENERAL
IA
01
—
42603840551401
WPS TRICARE
IA
01
—
703361027754
PREFERRED ONE
IA
01
—
P05392
COVENTRY HEALTH CARE
IA
Enumeration date
12/29/2005
Last updated
02/09/2023
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