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NPI Code Detail

MEDICARE: LUCIAN Y GROVE JR. M.D.

MEDICARE:   LUCIAN Y GROVE JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician0101038042VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538136932
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCIAN Y GROVE JR. M.D.
Provider Business Mailing Address
First Line : 1935 W MAIN ST
Second Line :
City : SALEM
State : VA
Zip : 24153-3109
Country : US
Telephone Number : 540-302-0190
Fax Number : 540-302-0191
Provider Business Practice Location Address
First Line : 1935 W MAIN ST
Second Line :
City : SALEM
State : VA
Zip : 24153-3109
Country : US
Telephone Number : 540-302-0190
Fax Number : 540-302-0191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 04/17/2015

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Directions to “ LUCIAN Y GROVE JR. M.D.” Practice Location

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