Individual
MICHAEL ROBERT GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
965 SHAMROCK LN, CORRY, PA 16407-1196
(814) 664-4641
(814) 664-8799
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
(814) 868-2507
(814) 868-2522
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
051467
GA
207P00000X
Emergency Medicine Physician
Primary
OS010419L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204624381C
—
GA
Enumeration date
06/12/2006
Last updated
12/19/2023
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