Individual
DR. ALEXANDER S GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 NORTHSIDE BLVD, SUITE 1500, CUMMING, GA 30041-7623
(770) 781-5077
(770) 781-3915
Mailing address
3379 PEACHTREE RD NE, STE 500, ATLANTA, GA 30326-1418
(770) 781-5077
(770) 781-3915
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
030078
GA
207NS0135X
Procedural Dermatology Physician
030078
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000509858D
—
GA
01
—
070015702
RR MEDICARE
GA
01
—
GRP6141
MEDICARE ID-TYPE UNSPECIFIED
GA
Enumeration date
01/17/2006
Last updated
06/17/2022
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