Provider Demographics
NPI:1952353724
Name:GROSSBERG, DAVID BURTON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BURTON
Last Name:GROSSBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2900 LINDEN LN
Mailing Address - Street 2:200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1265
Mailing Address - Country:US
Mailing Address - Phone:301-681-5700
Mailing Address - Fax:301-681-5599
Practice Address - Street 1:2900 LINDEN LN
Practice Address - Street 2:200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1265
Practice Address - Country:US
Practice Address - Phone:301-681-5700
Practice Address - Fax:301-681-5599
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036822207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4109731OtherAETNA PROVIDER NUMBER
MDA4700004OtherDC CAREFIRST NUMBER
MD400556OtherMARYLAND CAREFIRST #
MD5019OtherELDER HEALTH NUMBER
MD060047334OtherRAILROAD MCR NUMBER
MD286201800Medicaid
MD5019OtherELDER HEALTH NUMBER
MDB94974Medicare UPIN