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Individual

DAVID A GROSSBLAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., P.T.

Contact information

Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-3000
Mailing address
300 W CLARENDON AVE, SUITE 142, PHOENIX, AZ 85013-3420
(602) 234-1803
(602) 234-3748

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
44436
AZ
225100000X
Physical Therapist
5561
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
650026148
RAILROAD MEDICARE
AZ
05
747313
AZ
01
86080015085259C305
TRIWEST
AZ
Enumeration date
11/21/2005
Last updated
04/23/2014
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