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General NPI Number Information
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NPI Number | 1407947062
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Entity Type | Organization
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Legal Business Name | STEWART C GROSS MD
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 2660 MAIN STREET S 311
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City | BRIDGEPORT
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State | CT
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Zip | 06606
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Country | US
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Telephone | 203-367-4008
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Fax | 203-368-0292
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Provider Business Mailing Address
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Address Line | 2660 MAIN STREET S 311
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City | BRIDGEPORT
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State | CT
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Zip | 06606
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Country | US
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Telephone | 203-367-4008
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Fax | 203-368-0292
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Authorized Official
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Title or Position | OWNER
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Name | STEWART C GROSS
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Credential | MD
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Telephone | 203-367-4008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 002575
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | 29910
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License Number State | CT
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