Individual
DR. GREGORY ELLIOTT BROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
190 E BANNOCK ST, PEDIATRIC HOSPITALISTS, BOISE, ID 83712-6241
(208) 381-2645
Mailing address
7352 W RIM ACRES LN, BOISE, ID 83709-5558
(208) 381-2645
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M-12467
ID
208000000X
Pediatrics Physician
MD 60174015
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982938700
—
WA
Enumeration date
09/25/2009
Last updated
03/28/2016
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