Gross, Michael Leslie

Gross, Michael Leslie is an sole proprietor health care provider with primary practice located at 828 Healthy Way Suite 300, Virginia Beach VA 23462-7958. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Gross, Michael Leslie can be contacted via phone (757) 965-6165.

Contact Information

Primary practice address
828 Healthy Way Suite 300 Virginia Beach VA 23462-7958
Fax: (757) 965-6296
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 0101052313 Virginia

Profile Details

NPI number 1932105285
LBN Legal business name Gross, Michael Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 22nd, 2005
Last updated May 23rd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932105285 NPPES
Virginia MEDICAID 5900379
Virginia Other 77060
Virginia Other 075428
Virginia Other 890625A
Virginia Other 070008396

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