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General NPI Number Information
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NPI Number | 1023420486
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Entity Type | Individual
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Provider Name | MARIELLE SOPHIA GROSS M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2014
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Last Update Date | 02/23/2024
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Provider Practice Location Address
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Address Line | 12 ST PAUL DR
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1035
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Country | US
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Telephone | 717-217-6882
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Fax | 717-255-0157
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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Fax | 717-851-6969
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4404
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | FG7823378
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD470686
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License Number State | PA
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