Provider Demographics
NPI:1093709008
Name:GROVES, MEGAN E (MD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:E
Last Name:GROVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:8350 N CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-1104
Mailing Address - Country:US
Mailing Address - Phone:913-297-7472
Mailing Address - Fax:816-407-9053
Practice Address - Street 1:8350 N CHURCH RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1104
Practice Address - Country:US
Practice Address - Phone:913-297-7472
Practice Address - Fax:816-407-9053
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-31112207Q00000X
MO2004036182207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207399007Medicaid
KS200335310AMedicaid