Individual
DR. MILTON JAMES GROSENBACH JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD PC
Contact information
Practice address
3562 S LAPEER RD STE F, METAMORA, MI 48455-8998
(810) 678-8898
(810) 668-8808
Mailing address
3562 S LAPEER RD STE F, METAMORA, MI 48455-8998
(810) 678-8898
(810) 668-8808
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301003782
MI
106H00000X
Marriage & Family Therapist
4101005216
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0M43200
MEDICARE
MI
01
—
620G44601
HEALTHPLUS
MI
01
—
680D44501
BLUECROSS/BLUESHIELD
MI
01
—
OM43200
MEDICARE
MI
Enumeration date
08/09/2005
Last updated
10/28/2015
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