Provider Demographics
NPI:1649299546
Name:GROVER, ROBERT A (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:GROVER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905
Mailing Address - Country:US
Mailing Address - Phone:706-787-7228
Mailing Address - Fax:
Practice Address - Street 1:300 EAST HOSPITAL DRIVE
Practice Address - Street 2:DEPARTMENT OB/GYN
Practice Address - City:FORT GORDON
Practice Address - State:GA
Practice Address - Zip Code:90905
Practice Address - Country:US
Practice Address - Phone:706-787-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA86864207VF0040X
MO2018030728207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME011020OtherANTHEM BLUE SHIELD
ME12702099Medicaid
ME011020OtherANTHEM BLUE SHIELD
ME12702099Medicaid