Provider Demographics
NPI:1295706687
Name:GROVER, HARISH (MD)
Entity type:Individual
Prefix:DR
First Name:HARISH
Middle Name:
Last Name:GROVER
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 1:118 BROAD STREET
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:VA
Mailing Address - Zip Code:24084
Mailing Address - Country:US
Mailing Address - Phone:540-674-2485
Mailing Address - Fax:
Practice Address - Street 1:118 BROAD STREET
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:VA
Practice Address - Zip Code:24084
Practice Address - Country:US
Practice Address - Phone:540-674-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ75301207RG0100X
VA0101233646207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010270081Medicaid
VA010269768Medicaid
VA010270103Medicaid
VA010322031Medicaid
VA010270103Medicaid
010693C40Medicare PIN