Provider Demographics
NPI:1487718201
Name:GROSS, PETER G (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:G
Last Name:GROSS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:958 COUNTY LINE RD
Mailing Address - Street 2:CONESTOGA MEDICAL BLDG STE 106
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-2585
Mailing Address - Country:US
Mailing Address - Phone:610-525-8282
Mailing Address - Fax:610-525-7766
Practice Address - Street 1:958 COUNTY LINE RD
Practice Address - Street 2:CONESTOGA MEDICAL BLDG STE 106
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2585
Practice Address - Country:US
Practice Address - Phone:610-525-8282
Practice Address - Fax:610-525-7766
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2009-05-21
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Provider Licenses
StateLicense IDTaxonomies
PAMD029947E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology