Individual
DR. DOUGLAS GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-2715
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-2715
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2022041020
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2020
Last updated
12/14/2022
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