MEDICARE: DAVID GROEN MD

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	207Q00000X	Family Medicine Physician	35-07-0506-G	OH

General Provider Information

NPI Number	:	1841247061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID GROEN MD

Provider Business Mailing Address
First Line	:	1980 BETHEL RD
Second Line	:	SUITE 100
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1816
Country	:	US
Telephone Number	:	614-451-3114
Fax Number	:	614-545-4793

Provider Business Practice Location Address
First Line	:	1980 BETHEL RD
Second Line	:	SUITE 100
City	:	COLUMBUS
State	:	OH
Zip	:	43220-1816
Country	:	US
Telephone Number	:	614-451-3114
Fax Number	:	614-545-4793

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	09/30/2011

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Directions to “ DAVID GROEN MD” Practice Location

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