Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 4301108736 | MI |
N | 2080P0207X | Pediatric Hematology-Oncologist | D64510 | MD |
N | 2080P0207X | Pediatric Hematology-Oncologist | MD48043 | TN |
NPI | 1225175201 |
---|---|
Provider Name | Dr. Patrick Joseph Grohar |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503-2560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 14/10/2015 |