Organization
SHEBOYGAN UROLOGY SPECIALISTS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY S GROSE M.D. (PRESIDENT)
(920) 457-4858
Entity
Organization
Contact information
Practice address
1414 N TAYLOR DR, SUITE 210, SHEBOYGAN, WI 53081-1988
(920) 457-4858
(920) 457-3650
Mailing address
1414 N TAYLOR DR, SUITE 210, SHEBOYGAN, WI 53081-1988
(920) 457-4858
(920) 457-3650
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21270800
—
WI
Enumeration date
10/14/2005
Last updated
08/22/2020
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