Provider Demographics
NPI:1588808554
Name:GROVER, DEEPAK PARKASH (DO)
Entity Type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:PARKASH
Last Name:GROVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:686 DEKALB PIKE
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1258
Mailing Address - Country:US
Mailing Address - Phone:610-492-2020
Mailing Address - Fax:610-492-2021
Practice Address - Street 1:686 DEKALB PIKE
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1258
Practice Address - Country:US
Practice Address - Phone:610-492-2020
Practice Address - Fax:610-492-2021
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS014807207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024939070001Medicaid
PA1024939070001Medicaid