Organization
DARRYL S GROSS MD PC
Active
Other names
MEDICAL WEIGHT LOSS & FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VANESSA DENISE GROSS (OFFICE ADMINISTRATOR)
(770) 860-8860
Entity
Organization
Contact information
Practice address
2280 SALEM RD SE, SUITE 102, CONYERS, GA 30013-2003
(770) 860-8860
(770) 860-8890
Mailing address
2280 SALEM RD SE, SUITE 102, CONYERS, GA 30013-2003
(770) 860-8860
(770) 860-8890
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6702
MEDICARE GROUP NUMBER ASS
GA
Enumeration date
11/06/2007
Last updated
01/10/2013
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