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General NPI Number Information
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NPI Number | 1710944285
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Entity Type | Individual
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Provider Name | MAURO GROSSI MD
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Gender | Male
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 600 MOYE BLVD PCMH 288 WEST
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City | GREENVILLE
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State | NC
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Zip | 27834-4300
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Country | US
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Telephone | 252-744-4676
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Fax | 252-744-8199
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Provider Business Mailing Address
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Address Line | 600 MOYE BOULEVARD SUITE 333 PCMH MA
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City | GREENVILLE
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State | NC
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Zip | 27834
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Country | US
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Telephone | 252-744-2087
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Fax | 252-744-8199
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 200500591
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License Number State | NC
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