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Individual

EDWARD A DEL GROSSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1320 W. MAIN STREET, NEWARK, OH 43055-1822
(740) 348-4779
(740) 348-4740
Mailing address
P.O. BOX 948, 2112 CHERRY VALLEY RD.,, NEWARK, OH 43058-0948
(740) 522-3774
(740) 522-2221

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-079067
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000195585
ANTHEM BC/BS
05
2224524
OH
01
300124726
RAILROAD MEDICARE
01
310851206015
MEDICAL MUTUAL OF OHIO
Enumeration date
10/17/2006
Last updated
11/01/2011
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