Individual
BRUCE GROVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
589 SOUTH STATE STREET, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Mailing address
589 SOUTH STATE STREET, PROVO, UT 84606-5056
(801) 429-2000
(801) 429-2001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2634241205
UT
207VX0000X
Obstetrics Physician
2634241205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101858
UNITED HEALTH CARE
UT
01
—
107007185101
SELECT HEALTH
UT
01
—
37767
CHIP MEDICAID/PEHP
UT
01
—
5935032
AETNA
UT
01
—
870515716
GEHA
UT
05
—
870515716004
—
UT
05
—
870515716018
—
UT
01
—
870515716GR1
EMIA
UT
01
—
D0282
MEDICAID LICENSE #
UT
Enumeration date
07/20/2006
Last updated
05/20/2024
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