Individual
DAVID J. GROTE
Active
Individual
DAVID J. GROTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000844
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164465019
MEDICARE INDIVIDUAL NPI
IA
01
—
1417088907
WELLMARK GROUP NPI NUMBER
IA
01
—
DT7736
MEDICARE RR GROUP PTAN
IA
01
—
IB2763
MEDICARE GROUP PTAN
IA
01
—
IB2763004
MEDICARE INDIVIDUAL PTAN
IA
Enumeration date
06/14/2006
Last updated
08/16/2016
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