Organization
MICHAEL ALAN GROSSMAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALAN GROSSMAN MD (PHYSICIAN)
(334) 756-9604
Entity
Organization
Contact information
Practice address
4505 20TH AVE, VALLEY, AL 36854-3542
(334) 756-9604
(334) 756-9606
Mailing address
4505 20TH AVE, VALLEY, AL 36854-3542
(334) 756-9604
(334) 756-9606
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
35434
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD7925
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000181145E
MEDICAID
GA
05
—
009929055
—
AL
01
—
51007808
BCBSAL
AL
Enumeration date
02/29/2012
Last updated
02/29/2012
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