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General NPI Number Information
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NPI Number | 1922231240
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Entity Type | Organization
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Legal Business Name | NICHOLAS R GROCH DO LLC
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Dates
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Enumeration Date | 09/03/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 400 MEDICAL PARK DR SUITE 103
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City | DOVER
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State | OH
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Zip | 44622-3207
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Country | US
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Telephone | 330-343-9600
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Fax | 330-343-4410
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Provider Business Mailing Address
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Address Line | 400 MEDICAL PARK DR SUITE 103
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City | DOVER
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State | OH
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Zip | 44622-3207
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Country | US
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Telephone | 330-343-9600
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Fax | 330-343-4410
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Authorized Official
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Title or Position | SINGLE MEMBER
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Name | DR. NICHOLAS ROBERT GROCH
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Credential | D.O.
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Telephone | 330-343-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | OH
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