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NPI Code Detail

MEDICARE: DAVID LAURENCE GROSS PA

MEDICARE: DAVID LAURENCE GROSS PA
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
1363AM0700XMedical Physician AssistantA435SC

General Provider Information

NPI Number : 1578597480
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LAURENCE GROSS PA
Provider Business Mailing Address
First Line : PO BOX 3726
Second Line :
City : AUGUSTA
State : GA
Zip : 30914-3726
Country : US
Telephone Number : 706-863-9595
Fax Number : 888-745-3917
Provider Business Practice Location Address
First Line : 9330 MEDICAL PLAZA DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9104
Country : US
Telephone Number : 706-863-9595
Fax Number : 888-745-3917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 03/10/2025

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Directions to “ DAVID LAURENCE GROSS PA” Practice Location

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