Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THEODORE GROSS
ActivePediatrics · FRUITLAND, ID
Registration Details
- NPI Number
- 1922531508
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 10, 2017 (9.0488872295649 yrs)
- Last Updated
- Aug 5, 2025
- License
-
M-15894 (ID)
Practice Information
- Address
-
1100 NW 12TH STFRUITLAND, ID, 836195040Browse ID providers · Browse ZIP 83619
- Phone
- 2084526556
- Primary Specialty
-
Pediatrics
208000000X
- Additional Specialty
- Pediatrics
Other Pediatrics Providers in FRUITLAND, ID
| Name | Credential | NPI |
|---|---|---|
| ABBY LYNN DAVIS | — | 1124758479 |
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.