Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | D0066318 | MD |
NPI | 1043422306 |
---|---|
Provider Name | Dr. Marc Jonathan Grossman |
First Address | Rockville, MD 20852-3803 |
Second Address | Rockville, MD 20852-3803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 17/11/2008 |