Individual
TED GROSHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD31289
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102486
HEALTHLINK
MO
01
—
140113001
ARKANSAS MEDICAID
AR
05
—
200528107
—
MO
01
—
2086349901
KANSAS MEDICAID
KS
01
—
3730
BLUE SHIELD/BLUE CHOICE
MO
01
—
7509311
UNITED HEALTHCARE
MO
Enumeration date
05/22/2006
Last updated
08/16/2011
Update your record
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