Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 35131205 | OH |
NPI | 1033439047 |
---|---|
Provider Name | Dr. Andrew James Grossbach |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43203-1278 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2010 |
Last Update Date | 03/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0230808 | (05) | OH |