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NPI Code Detail

MEDICARE: VICTORIA L GROSS MD

MEDICARE: VICTORIA L GROSS MD
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
1207N00000XDermatology Physician0101243534VA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1070000459OTHERVAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21568558625OTHERVAUNITED HEALTHCARE
3355555OTHERVAANTHEM
4885825OTHERVASOUTHERN HEALTH
53183614OTHERVAAETNA
69186914OTHERVACIGNA

General Provider Information

NPI Number : 1568558625
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA L GROSS MD
Provider Business Mailing Address
First Line : 9816 MAYLAND DR
Second Line : 100
City : RICHMOND
State : VA
Zip : 23233-1457
Country : US
Telephone Number : 804-282-8510
Fax Number : 804-285-5750
Provider Business Practice Location Address
First Line : 9816 MAYLAND DR
Second Line : 100
City : RICHMOND
State : VA
Zip : 23233-1457
Country : US
Telephone Number : 804-282-8510
Fax Number : 804-285-5750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 02/06/2014

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Directions to “ VICTORIA L GROSS MD” Practice Location

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