Individual
DR. JOHN D GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
613 LONG POINT RD, SUITE 201, MT PLEASANT, SC 29464-8350
(843) 724-3456
(843) 724-3455
Mailing address
613 LONG POINT RD, SUITE 201, MT PLEASANT, SC 29464-8350
(843) 724-3456
(843) 724-3455
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
29610
SC
207W00000X
Ophthalmology Physician
NC200201921
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q0098F
—
SC
Enumeration date
08/04/2006
Last updated
05/04/2021
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