Individual
JAMES E GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000006
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015389300008
—
PA
05
—
0019400370003
—
PA
01
—
DA7401
RAILROAD MEDICARE
PA
01
—
P00070100
RAILROAD MEDICARE
—
Enumeration date
02/01/2006
Last updated
02/17/2021
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