Individual
MICHAEL L GROME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5885
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5885
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
00285
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719146
MS BCBS
WV
01
—
080076470
RR MC
WV
05
—
3810000508
—
WV
Enumeration date
02/14/2006
Last updated
06/05/2012
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