1174557490 NPI number — SUKHDEV S. GROVER, MD ASSOCIATES

Table of content: (NPI 1174557490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174557490 NPI number — SUKHDEV S. GROVER, MD ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SUKHDEV S. GROVER, MD ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174557490
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/09/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2640 PITCAIRN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONROEVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15146-3309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-274-4320
Provider Business Mailing Address Fax Number:
724-274-4332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2640 PITCAIRN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONROEVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15146-3309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-274-4320
Provider Business Practice Location Address Fax Number:
724-274-4332
Provider Enumeration Date:
07/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GROVER
Authorized Official First Name:
SUKHDEV
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-274-4320

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RS0012X , with the licence number: MD033946L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0007332980006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000000072324 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1001135 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 008512 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CC1786 . This is a "PALMETTO GBA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0080320 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 100943 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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