Doctor Name: | MICHAEL S GROSSMAN |
NPI Number: | 1265594758 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301039616 |
Business Practice Address: | 901 Lakeshore Drive Ishpeming, MI - 49849 |
Business Phone Number: | 9064852687 |
Business Fax Number: | 9064852730 |
Mailing Address: | 901 Lakeshore Drive, ISHPEMING |
State: | MI |
Postal Code: | 49849 |
Phone Number: | 9064852687 |
Fax Number: | 9064852730 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 05/12/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 4301039616 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |