Provider Demographics
NPI:1285480624
Name:GROVER, AJAY (PHD, HCLD(ABB))
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:
Last Name:GROVER
Suffix:
Gender:M
Credentials:PHD, HCLD(ABB)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1447 YORK CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3361
Mailing Address - Country:US
Mailing Address - Phone:336-214-4405
Mailing Address - Fax:
Practice Address - Street 1:1447 YORK CT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3361
Practice Address - Country:US
Practice Address - Phone:336-214-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician