Provider Demographics
NPI:1306986914
Name:GROVER, ARVIND K (MD)
Entity type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:K
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 FORDS RD
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:NJ
Mailing Address - Zip Code:07869-2123
Mailing Address - Country:US
Mailing Address - Phone:973-366-6232
Mailing Address - Fax:973-763-0505
Practice Address - Street 1:2168 MILLBURN AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2640
Practice Address - Country:US
Practice Address - Phone:973-763-5765
Practice Address - Fax:973-763-0505
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04641800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0285404Medicaid
NJ0285404Medicaid
540906Medicare ID - Type Unspecified