Provider Demographics
NPI:1689623365
Name:GROSS, ROBERT H (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3815 E BELL RD
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2122
Mailing Address - Country:US
Mailing Address - Phone:602-258-4321
Mailing Address - Fax:602-253-5917
Practice Address - Street 1:3815 E BELL RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2122
Practice Address - Country:US
Practice Address - Phone:602-258-4321
Practice Address - Fax:602-253-5917
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2019-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ24084207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZWCHYMMedicare Oscar/Certification
18WCHYM04Medicare ID - Type Unspecified
G16965Medicare UPIN