Grosserode, Michael J

Grosserode, Michael J is an individual health care provider with primary practice located at 301 Med Tech Pkwy Ste 280, Johnson City TN 37604-2364. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Grosserode, Michael J can be contacted via phone (423) 794-5550.

Contact Information

Primary practice address
301 Med Tech Pkwy Ste 280 Johnson City TN 37604-2364
Phone: (423) 794-5550
Fax: (423) 928-0394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 26879 Tennessee

Profile Details

NPI number 1710982848
LBN Legal business name Grosserode, Michael J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Mar 31st, 2021 - about 5 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 1710982848 NPPES
Tennessee MEDICAID 3091643

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