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Contact Information

MARK L GROSSETETE, M.D., PH.D.
117 CAMINO DE VIDA STE 300
SANTA ROSA, NM88435
 Phone: 575-472-4311
 Fax: 575-472-4313
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

Addiction Medicine

207LA0401X 05 Physician/Anesthesiology
 

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MARK L GROSSETETE · (Male)

NPI # 1447592498
Status Active
Credentials M.D., PH.D.
Entity Individual
Enumeration date 03/17/2013
Last updated 01/08/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • NM License # MD2017-0779
Hospital affiliation(s)
  • ALTA VISTA REGIONAL HOSPITAL - (Acute Care)
    104 LEGION DRIVE
    LAS VEGAS, NM 87701
  • GUADALUPE COUNTY HOSPITAL - (Acute Care)
    117 CAMINO DE VIDA, SUITE 100
    SANTA ROSA, NM 88435
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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