Provider Demographics
NPI:1134125859
Name:GROSSER, STEVEN JAY (MD)
Entity Type:Individual
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First Name:STEVEN
Middle Name:JAY
Last Name:GROSSER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5851 DULUTH ST
Mailing Address - Street 2:STE 215
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-3956
Mailing Address - Country:US
Mailing Address - Phone:763-546-8422
Mailing Address - Fax:763-546-8114
Practice Address - Street 1:5851 DULUTH ST
Practice Address - Street 2:STE 215
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-3956
Practice Address - Country:US
Practice Address - Phone:763-546-8422
Practice Address - Fax:763-546-8114
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2013-04-23
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Provider Licenses
StateLicense IDTaxonomies
MN40707207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN180033693OtherRAILROAD MEDICARE
MN28B11GROtherBCBS OF MN
MN0800118OtherMEDICA CHOICE
MN306522700Medicaid
MNG75203Medicare UPIN
MN306522700Medicaid