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Individual

HOWARD M. GRODMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
830 PENNSYLVANIA AVE, SUITE 103, CHARLESTON, WV 25302-3302
(304) 388-1552
(304) 388-1577
Mailing address
830 PENNSYLVANIA AVE, SUITE 103, CHARLESTON, WV 25302-3302
(304) 388-1552
(304) 388-1577

Taxonomy

Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
171678
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
171678
MEDICAL
NY
Enumeration date
08/22/2006
Last updated
06/09/2015
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