Provider Demographics
NPI:1710447321
Name:GROSS, CHRISTINE (MD, PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 RIBAUT RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-5454
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:318-232-5478
Practice Address - Street 1:955 RIBAUT RD
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-5454
Practice Address - Country:US
Practice Address - Phone:843-522-5200
Practice Address - Fax:318-232-5478
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC89746208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist