Individual
BARRY J GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9838 DIXIE HWY, FAIR HAVEN, MI 48023-2813
(586) 725-9611
(586) 725-2630
Mailing address
9838 DIXIE HWY, FAIR HAVEN, MI 48023-2813
(586) 725-9611
(586) 725-2630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101007067
MI
207QA0401X
Addiction Medicine (Family Medicine) Physician
5101007067
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1097101
—
MI
Enumeration date
04/19/2006
Last updated
02/16/2022
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