Individual
KENNETH DEAN GROSHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7550 WOLF RIVER BLVD, SUITE 200, GERMANTOWN, TN 38138-1745
(901) 542-6801
(901) 542-6871
Mailing address
7550 WOLF RIVER BLVD, SUITE 200, GERMANTOWN, TN 38138-1745
(901) 542-6801
(901) 542-6871
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD0000008167
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000004191
—
TN
05
—
0016392
—
MS
05
—
113592001
—
AR
05
—
202406807
—
MO
01
—
3031615
BLUE CROSS BLUE SHIELD
TN
05
—
3031615
—
TN
05
—
3040566
—
TN
01
—
96811
BLUE CROSS
AR
Enumeration date
07/04/2006
Last updated
12/09/2008
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