Individual
MEGAN BROOKE GROSSMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
(410) 496-7541
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
(410) 496-7541
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C04873
MD
Other
Enumeration date
10/04/2012
Last updated
11/21/2013
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