Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 35129355 | OH |
NPI | 1609957711 |
---|---|
Provider Name | Adam Theodore Groth |
First Address | Columbus, OH 43202-1559 |
Second Address | Columbus, OH 43202-1552 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 15/03/2021 |