Provider Demographics
NPI:1821043704
Name:GROW, JAMES FOSTER JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:FOSTER
Last Name:GROW
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:605 N CLEVELAND MASSILLON RD
Mailing Address - Street 2:STE. B
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-2241
Mailing Address - Country:US
Mailing Address - Phone:330-666-3333
Mailing Address - Fax:330-668-6532
Practice Address - Street 1:605 N CLEVELAND MASSILLON RD
Practice Address - Street 2:STE. B
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-2241
Practice Address - Country:US
Practice Address - Phone:330-666-3333
Practice Address - Fax:330-668-6532
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.030368207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0375325OtherMEDICARE ID
OH0274162Medicaid
0375326OtherMEDICARE ID
OH0274162Medicaid