Individual
GENE W GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2310 CALIFORNIA ROAD, ELKHART, IN 46514-1228
(574) 264-4163
(574) 262-9650
Mailing address
2310 CALIFORNIA ROAD, ELKHART, IN 46514-1228
(574) 264-4163
(574) 262-9650
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
01042513A
IN
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01042513A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100414860A
—
IN
Enumeration date
08/10/2006
Last updated
02/09/2012
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