Provider Demographics
NPI:1821065459
Name:GROVES, ARTHUR CHESTER IV (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:CHESTER
Last Name:GROVES
Suffix:IV
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 1:2175 N FORK DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3740
Mailing Address - Country:US
Mailing Address - Phone:973-494-2355
Mailing Address - Fax:
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2197
Practice Address - Country:US
Practice Address - Phone:786-596-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ353502085U0001X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCS7943OtherMEDICARE RAILROAD GROUP ID
AZ1841261989OtherGROUP NPI
AZ005472OtherGROUP MEDICAID ID
AZ087520Medicaid
AZ1821065459OtherPHYSICIAN INDIVIDUAL NPI
AZCS7943OtherGROUP MEDICARE RAILROAD ID & PTAN
FLME123824OtherFLORIDA MEDICAL LICENSE
AZP00318827OtherMEDICARE RAILROAD
AZZWCBBMOtherMEDICARE GROUP ID
I05107Medicare UPIN