Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 35.040838 | OH |
N | 207RH0003X | Hematology & Oncology | 35040838 | OH |
NPI | 1023057148 |
---|---|
Provider Name | Dr. Howard M Gross |
First Address | Dayton, OH 45414-2854 |
Second Address | Englewood, OH 45415-1183 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 06/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000389966 | ANTHEM (01) | |
0571840 | (05) | OH |