Individual
GROVER TRAVIS PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD FACS
Contact information
Practice address
2002 HAND AVENUE, BAY MINETTE, AL 36507
(251) 580-4243
(251) 580-4189
Mailing address
PO BOX 1405, BAY MINETTE, AL 36507
(251) 580-1760
(251) 621-6467
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
00021209
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009938989
—
AL
01
—
051003894
BCBS
AL
01
—
1861426454
GROUP NPI
AL
01
—
51106179
BCBS
AL
Enumeration date
07/03/2006
Last updated
03/07/2024
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