Provider Demographics
NPI:1265592380
Name:GROSS, DAVID ROBERT (PA-C)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ROBERT
Last Name:GROSS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 150750
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-0750
Mailing Address - Country:US
Mailing Address - Phone:303-984-5554
Mailing Address - Fax:303-984-5554
Practice Address - Street 1:3001 N JUNIPER ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:CO
Practice Address - Zip Code:80642-9400
Practice Address - Country:US
Practice Address - Phone:303-536-2637
Practice Address - Fax:303-536-9061
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2011-06-29
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Provider Licenses
StateLicense IDTaxonomies
CO1405363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical