DEREK I GROSSMAN (NPI# 1770512410) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770512410 |
| Entity Type | Individual |
| Full Name | DEREK I GROSSMAN |
| Credential | DO |
| Practice Address |
5365 Hidden Glen Dr Traverse City MI 49684-7042 |
| Mailing Address |
Po Box 107 Traverse City MI 49685-0107 |
| Practice Telephone | 9896215014 |
| Mailing Telephone | 2319229270 |
| Mailing Fax Number | 2319229271 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-05-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 5101011248 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4892891 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1105 Sixth St, Traverse City, MI 496842349 | 2319229270 | 2319229271 |
| Street Address |
5365 HIDDEN GLEN DR |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49684-7042 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124641758 | Karen Anne Paulosky | Registered Nurse | 226 S Madison St, Traverse City, MI 49684 | 2020-05-18 |
| 1891314795 | Jaclyn Elizabeth Sylvain | Student in an Organized Health Care Education/Training Program | Munson Family Practice Center, 1400 Medical Campus Drive, Traverse City, MI 49684 | 2020-04-10 |
| 1285282988 | Madelyn Drumm | Dietitian, Registered | 217 S. Madison St., Suite 3022, Traverse City, MI 49684 | 2019-08-27 |
| 1265917686 | Kacie Danielle Heading | Social Worker | 12719 S. West Bay Shore Drive, Suite 9, Traverse City, MI 49684 | 2018-10-02 |
| 1881178325 | Jacob White Ph.d., Pllc | Psychologist | 3537 W. Front Street, Suite F, Traverse City, MI 49684 | 2018-09-20 |
| 1144702572 | Constance Baab, Phd, Lmsw, Pllc | Social Worker | 3301 Veterans Drive Suite 127, Traverse City, MI 49684 | 2018-09-01 |
| 1346732880 | The Skin Cancer and Dermatology Center Plc | Dermatology | 1225 W Front St Ste 2, Traverse City, MI 49684 | 2018-05-31 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1114447646 | Brittany Alexandra Prior | Physical Therapist | 3899 W Front Sreet, Unit 3, Traverse City, MI 49684 | 2017-06-26 |
| 1568902963 | Jennifer Scott | Behavior Technician | 515 W 14th St Unit D, Traverse City, MI 49684 | 2017-03-03 |
| Find all providers in zip 49684 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902246689 | Heather Elizabeth Carroll | Internal Medicine | 4100 Park Forest Dr Ste 208, Traverse City, MI 49684-7306 | 2013-06-26 |
| 1992944193 | Mary Klemens Md Pllc | Internal Medicine | 800 Cottage View Dr, Suite 1080b, Traverse City, MI 49684-2490 | 2009-02-11 |
| 1144342262 | Jessica Lea Slocum | Internal Medicine | 4062 West Royal Drive, Traverse City, MI 49684-8965 | 2007-04-06 |
| 1013066406 | David R Hendricks | Internal Medicine | 153 1/2 E Front St, Traverse City, MI 49684-5729 | 2007-01-09 |
| 1699781658 | Dennis Sayong Sula | Internal Medicine | 1221 Sixth St Ste 206, Traverse City, MI 49684-2359 | 2006-07-31 |
| 1194779843 | Carl B Anders | Internal Medicine | 224 Circle Drive, Traverse City, MI 49684-2700 | 2006-05-19 |
| 1447202387 | Lorraine Marceil Nall | Internal Medicine | 3537 West Front Street, Ste I, Traverse City, MI 49684-7943 | 2006-05-17 |
| 1629034020 | Joseph Frank Messina | Internal Medicine | 4075 Copper River Drive, Traverse City, MI 49684 | 2006-04-25 |
| 1093776932 | Kenneth Richard Epstein | Internal Medicine | 4075 Copper Ridge Drive, Hospitalist Consultants, Inc., Traverse City, MI 49684 | 2006-03-30 |
| 1114986098 | Timothy R. Weichert | Internal Medicine | 4977 Skyview Ct, Traverse City, MI 49684-6941 | 2006-03-21 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49684 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.