Provider Demographics
NPI:1902256688
Name:GROLLMAN, ALBERT H (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:H
Last Name:GROLLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11300 ROLLING HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4539
Mailing Address - Country:US
Mailing Address - Phone:301-881-4461
Mailing Address - Fax:240-773-0301
Practice Address - Street 1:7 METROPOLITAN CT STE 1
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-4016
Practice Address - Country:US
Practice Address - Phone:240-773-0307
Practice Address - Fax:240-773-0301
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0002404174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist