Individual
MARTIN GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301046830
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300F362480
BCBSM
MI
05
—
4288161
—
MI
Enumeration date
03/24/2006
Last updated
10/31/2022
Update your record
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