Provider Demographics
NPI:1982920294
Name:GROBMAN, SIDNEY M (DO)
Entity Type:Individual
Prefix:
First Name:SIDNEY
Middle Name:M
Last Name:GROBMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 SILVERSIDE RD
Mailing Address - Street 2:SUITE 102, WELDIN BLDG
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4812
Mailing Address - Country:US
Mailing Address - Phone:302-479-0580
Mailing Address - Fax:
Practice Address - Street 1:3411 SILVERSIDE RD
Practice Address - Street 2:SUITE 102, WELDIN BLDG
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4812
Practice Address - Country:US
Practice Address - Phone:302-479-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2010-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS001850L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine