Provider Demographics
NPI:1164498598
Name:GROSS, HOLLY MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:MICHELE
Last Name:GROSS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5283 CORPORATE DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2877
Mailing Address - Country:US
Mailing Address - Phone:301-662-4545
Mailing Address - Fax:301-662-4044
Practice Address - Street 1:5283 CORPORATE DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-2877
Practice Address - Country:US
Practice Address - Phone:301-662-4545
Practice Address - Fax:301-662-4044
Is Sole Proprietor?:No
Enumeration Date:2006-02-26
Last Update Date:2011-01-05
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Provider Licenses
StateLicense IDTaxonomies
MDD47800207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG10432Medicare UPIN