Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 104399 | MN |
N | 111NI0900X | Internist | 104399 | MN |
N | 207R00000X | Internist | 4301087457 | MI |
N | 111NI0900X | Internist | 4301087457 | MI |
Y | 207RG0100X | Gastroenterologist | 52234 | MN |
NPI | 1033232608 |
---|---|
Provider Name | Dr. Madhusudan Grover |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 14/08/2020 |