Provider Demographics
NPI:1508827510
Name:GROSS, HERBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:S
Last Name:GROSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6416 DANVILLE CT
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3710
Mailing Address - Country:US
Mailing Address - Phone:301-770-6416
Mailing Address - Fax:301-770-6409
Practice Address - Street 1:6416 DANVILLE CT
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3710
Practice Address - Country:US
Practice Address - Phone:301-770-6416
Practice Address - Fax:301-770-6409
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD00014452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD38560OtherMAPSI
MDC46724Medicare UPIN