Provider Demographics
NPI:1831543149
Name:GROVES, DONALD (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:GROVES
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 1:350 S MIAMI AVE
Mailing Address - Street 2:UNIT 1108
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1909
Mailing Address - Country:US
Mailing Address - Phone:424-333-0744
Mailing Address - Fax:
Practice Address - Street 1:STONY BROOK MEDICINE DEPARTMENT OF SURGERY
Practice Address - Street 2:HEALTH SCIENCE TOWER, LEVEL 19, ROOM 030
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-0001
Practice Address - Country:US
Practice Address - Phone:631-444-1791
Practice Address - Fax:631-444-7689
Is Sole Proprietor?:No
Enumeration Date:2016-04-22
Last Update Date:2016-04-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program