Individual
STEPHEN ROBERT GROSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 DEACONESS RD, W-CC2, BOSTON, MA 02215-5321
(617) 754-2339
Mailing address
59 WOODLAND RD, WAYLAND, MA 01778-4134
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
248526
MA
207P00000X
Emergency Medicine Physician
Primary
257912
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110099662A
—
MA
Enumeration date
06/14/2011
Last updated
11/20/2020
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