Provider Demographics
NPI:1528054608
Name:GROVE, MICHELE SAK (MD)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:SAK
Last Name:GROVE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1100 WESCOTT DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:908-788-6469
Mailing Address - Fax:908-788-6483
Practice Address - Street 1:1100 WESCOTT DR
Practice Address - Street 2:SUITE 105
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4600
Practice Address - Country:US
Practice Address - Phone:908-788-6469
Practice Address - Fax:908-788-6483
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA06927600207V00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH05104Medicare UPIN