Individual
STEPHAN J GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1750 THOMPSON RD, COOS BAY, OR 97420-2100
(541) 269-0333
Mailing address
1750 THOMPSON RD, COOS BAY, OR 97420-2100
(541) 269-0333
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD22161
OR
207V00000X
Obstetrics & Gynecology Physician
Primary
MD22161
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134364
—
OR
Enumeration date
07/31/2006
Last updated
02/22/2024
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