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Individual

DR. ANDREW LANE GROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1501 E 3RD ST # 81416, DELTA, CO 81416-2815
(970) 874-7681
Mailing address
PO BOX 10100, DELTA, CO 81416-0008
(970) 874-7681

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
04-39723
KS
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
44054
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
22433031
CO
Enumeration date
08/30/2006
Last updated
12/14/2021
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