Provider Demographics
NPI:1396760633
Name:GROSH, ELLEN SMITH (MD)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:SMITH
Last Name:GROSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3524 LARCHMONT DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2854
Mailing Address - Country:US
Mailing Address - Phone:734-623-6330
Mailing Address - Fax:
Practice Address - Street 1:2020 HOGBACK RD STE 15
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9752
Practice Address - Country:US
Practice Address - Phone:734-971-0200
Practice Address - Fax:734-971-1677
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010809272084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry