Philip Sumner Grove, MD
Individual provider Active NPI Anatomic Pathology & Clinical Pathology Physician · Ranson, WV
NPI 1881815389 · NPPES record last updated Apr 30, 2008
Key facts
- NPI
- 1881815389
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician 207ZP0102X
- License
- 21973 (WV)
- Practice address
- 300 S Preston Street
Ranson, WV 25438 - Phone
- (304) 293-7401
- Fax
- (304) 293-6963
- NPI assigned
- May 1, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21973 | WV | MD | Anatomic Pathology & Clinical Pathology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ameripath Milwaukee SC | Anatomic Pathology & Clinical Pathology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 21973 | WV | Yes |
Addresses
Primary practice location
300 S Preston Street
Ranson, WV 25438
Mailing address
PO Box 780
Morgantown, WV 26507-0780
Phone (304) 293-5033
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810003249 | Medicaid | WA |
Other providers in Ranson, WV
- Wendy L. Fletcher
- Karen C Frail
- Beverly Joann Garrett
- Quinton Gray
- Robert Green
- Vignesh Gunasekaran
- Jennifer Sue Gutierrez
- Stacey Corinne Hanlon-Milanesa
- Destiny Imani Hardy
- John Heinen
All providers in Ranson, WV · Anatomic Pathology & Clinical Pathology Physician in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.