Individual
MICHAEL GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4505 20TH AVE, VALLEY, AL 36854-3542
(334) 756-9604
(334) 756-9606
Mailing address
PO BOX 315, VALLEY, AL 36854-0315
(334) 756-9604
(334) 756-9606
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00007925
AL
207R00000X
Internal Medicine Physician
Primary
MD.7925
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000181145E
—
GA
05
—
009929055
—
AL
01
—
51516975
BC/BS ALABAMA
AL
Enumeration date
07/21/2005
Last updated
03/22/2022
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