MEDICARE: MR. ROBERT JOHN GROVE CSFA

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
1	246ZC0007X	Surgical Assistant	0136000066	VA

General Provider Information

NPI Number	:	1790635530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT JOHN GROVE CSFA

Provider Business Mailing Address
First Line	:	103 MEADOWCREST TRL
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-7036
Country	:	US
Telephone Number	:	757-719-6199
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 SENTARA CIR
Second Line	:
City	:	WILLIAMSBURG
State	:	VA
Zip	:	23188-5713
Country	:	US
Telephone Number	:	757-984-7782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2026
Last Update Date	:	01/31/2026

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Directions to “ MR. ROBERT JOHN GROVE CSFA” Practice Location

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