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NPI Code Detail

MEDICARE: RICHARD MICHAEL GROSS M.D.

MEDICARE:   RICHARD MICHAEL GROSS  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician14104NE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114914OTHERNEMIDLANDS CHOICE
209-01135OTHERNESHARE ADVANTAGE/LAKESIDE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
402647OTHERNEBCBS OF NEBRASKA
509-00178OTHERNESHARE ADVANTAGE/MERCY RD
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033150677
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD MICHAEL GROSS M.D.
Provider Business Mailing Address
First Line : 17030 LAKESIDE HILLS PLZ
Second Line : SUITE 200
City : OMAHA
State : NE
Zip : 68130-2396
Country : US
Telephone Number : 402-399-8550
Fax Number : 402-399-8455
Provider Business Practice Location Address
First Line : 7710 MERCY RD
Second Line : SUITE 224
City : OMAHA
State : NE
Zip : 68124-2372
Country : US
Telephone Number : 402-399-8550
Fax Number : 402-399-8455
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 04/15/2010

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Directions to “ RICHARD MICHAEL GROSS M.D.” Practice Location

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