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NPI Code Detail

MEDICARE: DR. FARREL IRVIN GROSSMAN D.C.

MEDICARE: DR. FARREL IRVIN GROSSMAN D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NS0005XSports Physician Chiropractor1075SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336161405
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FARREL IRVIN GROSSMAN D.C.
Provider Business Mailing Address
First Line : 283 DORCHESTER MANOR BLVD
Second Line :
City : N CHARLESTON
State : SC
Zip : 29420-8108
Country : US
Telephone Number : 843-552-8000
Fax Number : 843-552-0093
Provider Business Practice Location Address
First Line : 283 DORCHESTER MANOR BLVD
Second Line :
City : N CHARLESTON
State : SC
Zip : 29420-8108
Country : US
Telephone Number : 843-552-8000
Fax Number : 843-552-0093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 07/21/2022

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