# DR. MICHAEL J GROSSMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1831188218
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 48692 | MA | Yes |

## Other

- **Enumeration date:** 10/18/2005
- **Last updated:** 02/18/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 3131696 | — | MA |
| 01 | — | J03100 | MEDICARE | — |