Individual
DR. CHARLES LOUIS GROOMES IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-4691
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101254907
VA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
0101254907
VA
Other
Enumeration date
06/08/2012
Last updated
08/29/2023
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