| Organization Name: | SCOTT GRODMAN DPM PC |
| NPI Number: | 1750564050 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SCOTT T GRODMAN (OWNER) |
| Mailing Address: | 9300 Pardee Rd Taylor |
| State: | MI US |
| Postal Code: | 481803528 |
| Phone Number: | 2485472450 |
| Fax Number: | 2485474598 |
| NPI Enumeration Date: | 12/10/2007 |
| NPI Last Update Date: | 01/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 001478 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |