Provider Demographics
NPI:1235240961
Name:GROSS, MILTON DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:MILTON
Middle Name:DAVID
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DR
Practice Address - Street 2:B1 FLOOR UNIVERSITY HOSPITAL ROOM B1G412
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5028
Practice Address - Country:US
Practice Address - Phone:734-936-5090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301035371207R00000X, 207RE0101X, 207U00000X, 207UN0903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0903XAllopathic & Osteopathic PhysiciansNuclear MedicineIn Vivo & In Vitro Nuclear Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1367539Medicaid
MI1367539Medicaid
MIB48011Medicare UPIN