THEODORE GROSS

Pediatrics

Active Individual
NPI: 1922531508

Practice Address

1100 NW 12TH ST
Fruitland, ID 83619

Phone: (208) 452-6556

Specialties

Specialty Code Primary License
Student in an Organized Health Care Education/Training Program 390200000X No -
Pediatrics 208000000X Yes M-15894 (ID)

Frequently Asked Questions

NPI 1922531508 is the National Provider Identifier for THEODORE GROSS, a Pediatrics provider located in Fruitland, ID. This NPI was enumerated on April 10, 2017.
THEODORE GROSS practices at 1100 NW 12TH ST, Fruitland, ID 83619.

Quick Facts

NPI
1922531508
Type
Individual
Enumerated
Apr 10, 2017
Last Updated
Aug 5, 2025

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