Individual
DR. MATTHEW C GROTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
208 COLUMBUS ST, HICKSVILLE, OH 43526
(419) 542-5669
(419) 542-5667
Mailing address
208 COLUMBUS ST, HICKSVILLE, OH 43526-1299
(419) 542-5669
(419) 542-5667
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35087589
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2791331
—
OH
01
—
35-087589
LICENSE
OH
01
—
P00453968
RAILROAD
OH
Enumeration date
07/22/2006
Last updated
08/14/2018
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