Individual
GARY PAUL GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1802 BRAEBURN DR, SALEM, VA 24153-7357
(540) 772-3421
(540) 772-5994
Mailing address
1802 BRAEBURN DRIVE, SALEM, VA 24153-7357
(540) 772-3421
(540) 772-5994
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101029581
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005900816
—
VA
01
—
P00276914
MEDICARE RAILROAD
VA
Enumeration date
01/11/2006
Last updated
08/16/2010
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