Provider Demographics
NPI:1871664995
Name:GROOVER, ANN MONTANARO (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MONTANARO
Last Name:GROOVER
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 1:2945 MILLER FERRY RD SW
Mailing Address - Street 2:SUITE D
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-7538
Mailing Address - Country:US
Mailing Address - Phone:706-602-9234
Mailing Address - Fax:706-602-9235
Practice Address - Street 1:2945 MILLER FERRY RD SW
Practice Address - Street 2:SUITE D
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-7538
Practice Address - Country:US
Practice Address - Phone:706-602-9234
Practice Address - Fax:706-602-9235
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0367652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000924118CMedicaid
F26227Medicare UPIN
GA000924118CMedicaid