Organization
ANESTHESIA GROUP PRACTICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK GROSSMAN (CEO)
(513) 817-1150
Entity
Organization
Contact information
Practice address
10500 MONTGOMERY RD, MONTGOMERY, OH 45242-4402
(513) 817-1150
(513) 351-0316
Mailing address
PO BOX 632572, CINCINNATI, OH 45263-2572
(859) 341-2666
(513) 351-0316
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100009200
—
IN
05
—
4127751
—
OH
05
—
65942781
—
KY
05
—
7100392750
—
KY
05
—
7100393520
—
KY
05
—
74900911
—
KY
Enumeration date
06/13/2005
Last updated
10/16/2025
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