Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK LAND GROSSETETE, M.D., PH.D.
ActiveDR. MARK LAND GROSSETETE, M.D., PH.D. is a Neurology healthcare provider located in SANTA ROSA, New Mexico. NPI 1447592498 is currently active in the NPPES registry. Verify at CMS.
Neurology · SANTA ROSA, NM
Registration Details
- NPI Number
- 1447592498
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 17, 2013 (13.37316138568 yrs)
- Last Updated
- Jan 8, 2024
- Licenses
-
MD2017-0779 (NM)MD2017-0779 (NM)MD2017-0779 (NM)MD2017-0779 (NM)
Practice Information
- Address
-
117 CAMINO DE VIDA STE 300SANTA ROSA, NM, 88435Browse NM providers · Browse ZIP 88435
- Phone
- 5754724311
- Fax
- 5754724313
- Primary Specialty
-
Neurology
2084N0400X
- Additional Specialty
- Addiction Medicine (Anesthesiology)
- Additional Specialty
- Internal Medicine
- Additional Specialty
- Vascular Surgery
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.