Provider Demographics
NPI:1437227923
Name:NORTH POINT MEDICAL CENTER PC
Entity Type:Organization
Organization Name:NORTH POINT MEDICAL CENTER PC
Other - Org Name:BARRY J GROSS DO PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:586-725-9611
Mailing Address - Street 1:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:ANCHORVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48004-0327
Mailing Address - Country:US
Mailing Address - Phone:586-725-9611
Mailing Address - Fax:586-725-2630
Practice Address - Street 1:9838 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:IRA
Practice Address - State:MI
Practice Address - Zip Code:48023-2813
Practice Address - Country:US
Practice Address - Phone:586-725-9611
Practice Address - Fax:586-725-2630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007067207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1097101 TYPE 11Medicaid
TXG7223OtherLICENSE
NMA-663-77OtherLICENSE
MI5101007067OtherLICENSE
MIE39807OtherHAP
MI0857400645OtherBCBS PROVIDER
MIAG7591628OtherDEA
MIAG7591628OtherDEA
MIE39807OtherHAP