Provider Demographics
NPI:1154315547
Name:GROVER, JASWINDER S (MD)
Entity Type:Individual
Prefix:
First Name:JASWINDER
Middle Name:S
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 SMOKE RANCH RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-3157
Mailing Address - Country:US
Mailing Address - Phone:702-320-8111
Mailing Address - Fax:702-320-8112
Practice Address - Street 1:7140 SMOKE RANCH RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3157
Practice Address - Country:US
Practice Address - Phone:702-320-8111
Practice Address - Fax:702-320-8112
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2024-03-08
Deactivation Date:2006-03-31
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
NVNEVADA 7358207XS0117X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100503675Medicaid
NV100503675Medicaid
NV39884Medicare ID - Type Unspecified