Provider Demographics
NPI:1437204161
Name:GROVES, R. JOHN (MD)
Entity Type:Individual
Prefix:
First Name:R. JOHN
Middle Name:
Last Name:GROVES
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 1:68 BROOKSSTATION RD
Mailing Address - Street 2:P.O. BOX 183
Mailing Address - City:PRINCETON
Mailing Address - State:MA
Mailing Address - Zip Code:01541
Mailing Address - Country:US
Mailing Address - Phone:508-752-0062
Mailing Address - Fax:
Practice Address - Street 1:120 STAFFORD ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-1457
Practice Address - Country:US
Practice Address - Phone:508-752-0062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35374207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery