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NPI Code Detail

MEDICARE: MR. KEVIN T GROH CRNA

MEDICARE: MR. KEVIN T GROH CRNA
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
1367500000XCertified Registered Nurse AnesthetistAPRN.CRNA.01744OH

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 : 1851341788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN T GROH CRNA
Provider Business Mailing Address
First Line : 4665 DOUGLAS CIR NW STE 100
Second Line :
City : CANTON
State : OH
Zip : 44718-3673
Country : US
Telephone Number : 330-499-5700
Fax Number :
Provider Business Practice Location Address
First Line : 659 BOULEVARD ST
Second Line :
City : DOVER
State : OH
Zip : 44622-2026
Country : US
Telephone Number : 330-602-0767
Fax Number : 330-365-3831
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 09/29/2025

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