Individual
KELLY GROB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1517 ROCK SPRING RD, FOREST HILL, MD 21050-2818
(410) 838-6358
Mailing address
1215 LEE ST, BOX 800499, CHARLOTTESVILLE, VA 22908-0816
(434) 924-5348
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0089246
MD
207QS0010X
Sports Medicine (Family Medicine) Physician
D0089246
MD
Other
Enumeration date
04/01/2016
Last updated
08/12/2020
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