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NPI Code Detail

MEDICARE: ERICH K GROMMET PH.D.

MEDICARE: ERICH K GROMMET PH.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
1103TM1800XIntellectual & Developmental Disabilities PsychologistPS2448ME
2103TM1800XIntellectual & Developmental Disabilities Psychologist023148NY
3103TM1800XIntellectual & Developmental Disabilities Psychologist2289AL
4103K00000XBehavior Analyst2018-003AL

General Provider Information

NPI Number : 1053020065
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICH K GROMMET PH.D.
Provider Business Mailing Address
First Line : 6001 CRESTWOOD BLVD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35212-4203
Country : US
Telephone Number : 205-316-9939
Fax Number : 205-961-3007
Provider Business Practice Location Address
First Line : 6001 CRESTWOOD BLVD
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35212-4203
Country : US
Telephone Number : 205-316-9939
Fax Number : 205-961-3007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2022
Last Update Date : 06/04/2026

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