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NPI Code Detail

MEDICARE: DANIEL ROBERT GROSSMAN MD

MEDICARE: DANIEL ROBERT GROSSMAN MD
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
1207Q00000XFamily Medicine Physician41579WI
2207Q00000XFamily Medicine Physician27879CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3513142OTHERCOMEDICARE GROUP NUMBER

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
241579OTHERWILICENSE

General Provider Information

NPI Number : 1346224169
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIEL ROBERT GROSSMAN MD
Provider Business Mailing Address
First Line : 7625 W 92ND AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80021-4567
Country : US
Telephone Number : 303-254-7464
Fax Number : 303-252-9875
Provider Business Practice Location Address
First Line : 7625 W 92ND AVE
Second Line :
City : WESTMINSTER
State : CO
Zip : 80021-4567
Country : US
Telephone Number : 303-254-7464
Fax Number : 303-252-9875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2005
Last Update Date : 08/24/2016

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Directions to “ DANIEL ROBERT GROSSMAN MD” Practice Location

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