Provider Demographics
NPI:1710951694
Name:GROSSMAN, HOWARD ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ALAN
Last Name:GROSSMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:615-315-5257
Mailing Address - Fax:615-692-0547
Practice Address - Street 1:3830 E FLAMINGO RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-6234
Practice Address - Country:US
Practice Address - Phone:725-269-1044
Practice Address - Fax:725-269-1046
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 128398207R00000X
NY162479207R00000X
IL036.158387207R00000X
NV22999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY162479OtherNEW YORK MEDICAL LICENSE
IL036.158387Medicaid
NJ25MA08735200OtherNJ LICENSE
FL128398OtherFLORIDA MEDICAL LICENSE