MEDICARE: DR. NORMAN ARMIN GROSSL 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
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	2000171130	MO

General Provider Information

NPI Number	:	1295953776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN ARMIN GROSSL M.D.

Provider Business Mailing Address
First Line	:	651 CASTLE MEADOWS CT
Second Line	:
City	:	BALLWIN
State	:	MO
Zip	:	63021-4447
Country	:	US
Telephone Number	:	636-527-3429
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 CONCOURSE DR
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63146-4119
Country	:	US
Telephone Number	:	314-567-3905
Fax Number	:	314-872-7155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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