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General NPI Number Information
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NPI Number | 1790717890
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Entity Type | Individual
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Provider Name | DAVID I GROMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 99 BEAUVOIR AVE
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City | SUMMIT
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State | NJ
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Zip | 07901-3533
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Country | US
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Telephone | 908-522-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 10 MICHAEL RD
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City | MENDHAM
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State | NJ
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Zip | 07945-2400
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Country | US
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Telephone | 313-549-8698
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD2006-0076
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MA09225500
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License Number State | NJ
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