Individual
GEORGE T GROSSBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1438 S GRAND BLVD, SAINT LOUIS, MO 63104-1027
(314) 977-4829
(314) 268-5494
Mailing address
1438 S GRAND BLVD, PROVIDER ENROLLMENT, SAINT LOUIS, MO 63104-1027
(314) 977-4825
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R6957
MO
2084P0805X
Geriatric Psychiatry Physician
R6957
MO
Other
Enumeration date
07/14/2006
Last updated
01/12/2021
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