Provider Demographics
NPI:1235109737
Name:GROARK, SEAN PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:PATRICK
Last Name:GROARK
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 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-539-4080
Mailing Address - Fax:256-539-4099
Practice Address - Street 1:930 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4312
Practice Address - Country:US
Practice Address - Phone:256-539-4080
Practice Address - Fax:256-539-4099
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18768207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
060037254OtherRAILROAD MEDICARE
4624195OtherAETNA
AL51049408OtherBCBS
AL111844Medicaid
AL111891Medicaid
AL51049407OtherBCBS
AL51598608OtherBCBS
AL111846Medicaid
25-10051OtherUNITED HEALTHCARE
AL51049241OtherBCBS
ALP00744666OtherRAILROAD MEDICARE
AL111470Medicaid
AL51049242OtherBCBS
AL51049243OtherBCBS
AL111888Medicaid
TN3035375OtherBCBS
AL51033803OtherBCBS
AL000033803Medicaid
AL111468Medicaid
TN3035375OtherBCBS
25-10051OtherUNITED HEALTHCARE
AL111844Medicaid
4624195OtherAETNA