Provider Demographics
NPI:1427143387
Name:GROSS, ROBERT (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GROSS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6255 INKSTER RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2577
Mailing Address - Country:US
Mailing Address - Phone:734-458-4492
Mailing Address - Fax:734-458-7538
Practice Address - Street 1:6255 INKSTER RD
Practice Address - Street 2:SUITE 204
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2577
Practice Address - Country:US
Practice Address - Phone:734-458-4492
Practice Address - Fax:734-458-7538
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-03-18
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Provider Licenses
StateLicense IDTaxonomies
MI5101012468 1626339208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery