Healthcare Provider Details
I. General information
NPI: 1235282906
Provider Name (Legal Business Name): GROSCHAN AND ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/18/2007
Last Update Date: 07/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2328 W JOPPA RD SUITE 300
LUTHERVILLE MD
21093-4612
US
IV. Provider business mailing address
2328 W JOPPA RD SUITE 300
LUTHERVILLE MD
21093-4612
US
V. Phone/Fax
- Phone: 410-938-8660
- Fax: 410-938-8664
- Phone: 410-938-8660
- Fax: 410-938-8664
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 15102 |
| License Number State | MD |
VIII. Authorized Official
Name: MS.
MICHELLE
LYNN
SCHAFFNER
Title or Position: OFFICE MANAGER
Credential:
Phone: 410-938-8660