Provider Demographics
NPI:1629045646
Name:GROSKIN, STEPHEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:GROSKIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1070
Mailing Address - Street 2:PRIMA CARE, PC
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02722-1070
Mailing Address - Country:US
Mailing Address - Phone:508-676-3292
Mailing Address - Fax:508-672-7181
Practice Address - Street 1:546 MAIN ROAD
Practice Address - Street 2:PRIMA CARE, PC
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-1350
Practice Address - Country:US
Practice Address - Phone:401-816-5110
Practice Address - Fax:401-816-5480
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2016-06-24
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Provider Licenses
StateLicense IDTaxonomies
RIMD12295207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D03201Medicare UPIN