Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 035059 | GA |
N | 111NI0900X | Internist | 035059 | GA |
Y | 207RH0002X | Hospice and Palliative Medicine | 035059 | GA |
NPI | 1346338720 |
---|---|
Provider Name | Michael H Groover |
First Address | Athens, GA 30604-8089 |
Second Address | Athens, GA 30606-3712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 07/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00588189C | (05) | GA |
F73258 | (02) | GA |