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Individual

DR. BONNIE SIMON GROSSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
14 RICHLAND MEDICAL PARK DR STE 320, COLUMBIA, SC 29203
(803) 434-6771
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(843) 679-4217

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
33846
SC
208M00000X
Hospitalist Physician
Primary
33846
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
338469
SC
Enumeration date
06/28/2011
Last updated
03/05/2024
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