| Michael Robert Grossman, DO | |
|
965 Shamrock Ln, Corry, PA 16407-1196 | |
| (814) 664-4641 | |
| (814) 664-8799 |
| Full Name | Michael Robert Grossman |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 965 Shamrock Ln, Corry, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710929708 | NPI | - | NPPES |
| 204624381C | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 051467 (Georgia) | Secondary |
| 207P00000X | Emergency Medicine | OS010419L (Pennsylvania) | Primary |
| Entity Name | Donalsonville Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720095805 PECOS PAC ID: 7113919820 Enrollment ID: O20040401001194 |
| Entity Name | Sterling Initiatives |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295581973 PECOS PAC ID: 6709100811 Enrollment ID: O20240718001411 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Robert Grossman, DO 1 Lecom Pl, Erie, PA 16505-2571 Ph: (814) 868-2507 | Michael Robert Grossman, DO 965 Shamrock Ln, Corry, PA 16407-1196 Ph: (814) 664-4641 |
Dr. Michael Antoon, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 612 W Smith St, Corry, PA 16407 Phone: 180-083-4486 | |
Dr. Jonathan L Spaulding, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 965 Shamrock Ln, Corry, PA 16407 Phone: 814-664-4641 Fax: 814-663-9900 |