Provider Demographics
NPI:1891022661
Name:GROPPER, ADRIAN (MD)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:GROPPER
Suffix:
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 1:52 MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02472-4711
Mailing Address - Country:US
Mailing Address - Phone:617-395-6744
Mailing Address - Fax:
Practice Address - Street 1:52 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4711
Practice Address - Country:US
Practice Address - Phone:617-395-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-15
Last Update Date:2009-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44984208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice