# MR. DOUGLAS L GROSSMANN

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

## Provider details

- **NPI number:** 1679550727
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 001252 | IA | Yes |

## Other

- **Enumeration date:** 12/29/2005
- **Last updated:** 02/09/2023

## 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 |