Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 73170 | MT |
NPI | 1023455748 |
---|---|
Provider Name | Dr. Michael Thompson Groover |
First Address | Billings, MT 59101-7507 |
Second Address | Billings, MT 59101-7507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 05/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FG7030694 | DEA (01) | MT |