NPI 1083751366 · live from the CMS NPI Registry
Jeffrey Wayne Grossman, MD
Radiology, Diagnostic Radiology in Coeur D Alene, ID. National Provider Identifier 1083751366, active.
NPI record
| NPI | 1083751366 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 2031 E Mountain Vista Dr, Coeur D Alene, ID 83815 |
| Practice phone | 208-570-3342 |
| Mailing address | 22100 Bothell Everett Hwy, Bothell, WA 98021 |
| Enumerated | January 30, 2007 |
| Last updated | July 6, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology primary | 2085R0202X | M-10276 (ID) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.