Provider Demographics
NPI:1619904901
Name:GROVER, NITA NOEL (MD)
Entity Type:Individual
Prefix:
First Name:NITA
Middle Name:NOEL
Last Name:GROVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 BRIDGE ST STE 9
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-4922
Mailing Address - Country:US
Mailing Address - Phone:603-415-0090
Mailing Address - Fax:833-944-2250
Practice Address - Street 1:24 BRIDGE ST STE 9
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-4922
Practice Address - Country:US
Practice Address - Phone:603-415-0090
Practice Address - Fax:833-944-2250
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH16448208VP0014X, 207LP2900X, 207L00000X, 2083A0300X, 207LP2900X, 2083A0300X
NHLT-3333207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3091977Medicaid