Healthcare Provider Details

I. General information

NPI: 1851367601
Provider Name (Legal Business Name): ERIK MICHAEL GROSSMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOSPITAL DR
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

3220 BLUFF CREEK DR SUITE 100
COLUMBIA MO
65201-3663
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-2100
  • Fax: 573-882-6054
Mailing address:
  • Phone: 573-443-8773
  • Fax: 573-443-6843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number110753
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number110753
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: