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STACIE GROSSFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4001 KRESGE WAY, STE 330, LOUISVILLE, KY 40207-4640
(502) 212-2663
(502) 212-2004
Mailing address
4001 KRESGE WAY, STE 330, LOUISVILLE, KY 40207-4640
(502) 212-2663
(502) 212-2004

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
33575
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1299470001
PTAN
KY
Enumeration date
05/23/2005
Last updated
09/14/2011
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