Individual
JEANNE THERESE GROSSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1263 HOSPITAL DR NW STE 250, CORYDON, IN 47112-2176
(812) 738-8136
(812) 738-3155
Mailing address
1263 HOSPITAL DR NW STE 250, CORYDON, IN 47112-2176
(812) 738-8136
(812) 738-3155
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01049002A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000335249
ANTHEM
IN
05
—
200239440
—
IN
01
—
P00202390
RR MEDICARE
IN
Enumeration date
10/11/2005
Last updated
08/06/2010
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