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Individual

MICHAEL JAMES GROSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
305 W COLLEGE AVE, SUITE A, SHELBY, NC 28152-8111
(704) 434-9686
(704) 434-9618
Mailing address
373 DARK CORNER RD, RUTHERFORDTON, NC 28139-6757
(704) 418-1210
(704) 434-9618

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
9501262
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1007P
BCBS IND
NC
05
891007P
NC
Enumeration date
01/07/2006
Last updated
02/09/2015
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