Sidney E. Grossberg, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

WI-15815-020 Issued in WI

Practice address

8701 W Watertown Plank Rd # Ccn2542
Medical College of Wisconsin
Milwaukee, WI 53226-3548

Phone

(414) 456-8105

Fax

(414) 456-6566

NPI assigned

Aug 21, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187654400000",
    "number": "1114110335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8701 W WATERTOWN PLANK RD # CCN2542",
            "address_2": "MEDICAL COLLEGE OF WISCONSIN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263548",
            "telephone_number": "414-456-8105",
            "fax_number": "414-456-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8701 W WATERTOWN PLANK RD # CCN2542",
            "address_2": "MEDICAL COLLEGE OF WISCONSIN",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263548",
            "telephone_number": "414-456-8105",
            "fax_number": "414-456-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSBERG",
        "first_name": "SIDNEY",
        "middle_name": "E.",
        "name_prefix": "Prof.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "WI-15815-020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Oli Grosland, M.D.
• Elizabeth Gross, LPC
• Julia Mae Gross, RDH
• Stephanie Gross, DNP, CPNP-PC
• William Louis Gross, MD, PHD
• Molly E Grosse
• William J Grossman, MD
• Jacqueline Grossoehme
• Travis Groth, M.D.
• Victoria E Groth

• Internal Medicine Physician in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.