NPI 1154941102

Douglas Grove, MD

Practitioner General Practice Physician Milwaukee, WI

Practice location

Address: 9200 W Wisconsin Ave, Milwaukee, WI 53226-3522
Phone: (414) 805-2715

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 2022041020 (MO)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1154941102
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Apr 2020
Record last updated: 14 Dec 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.