Provider Demographics
NPI:1831268952
Name:GRUMET, ROSS FREDRICK (MD)
Entity type:Individual
Prefix:
First Name:ROSS
Middle Name:FREDRICK
Last Name:GRUMET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1718 PEACHTREE STREET
Mailing Address - Street 2:STE 1080
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-685-9414
Mailing Address - Fax:404-685-9420
Practice Address - Street 1:1718 PEACHTREE STREET
Practice Address - Street 2:STE 1080
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-685-9414
Practice Address - Fax:404-685-9420
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0115962084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
D29632Medicare UPIN