Provider Demographics
NPI:1043268188
Name:GROSS, WILLIAM STEPHEN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:STEPHEN
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4049 HIDDEN WOODS DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301
Mailing Address - Country:US
Mailing Address - Phone:248-933-3050
Mailing Address - Fax:248-562-3229
Practice Address - Street 1:4049 HIDDEN WOODS DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301
Practice Address - Country:US
Practice Address - Phone:248-933-3050
Practice Address - Fax:248-562-3229
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2021-08-25
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Provider Licenses
StateLicense IDTaxonomies
MI43010366382086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB47353Medicare UPIN