Provider Demographics
NPI:1730390600
Name:GROVER, INDERPREET S (MD)
Entity type:Individual
Prefix:DR
First Name:INDERPREET
Middle Name:S
Last Name:GROVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 24146
Mailing Address - Street 2:UNIVERSITY PHYSICIANS, PLLC
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-4146
Mailing Address - Country:US
Mailing Address - Phone:601-984-5601
Mailing Address - Fax:601-984-6665
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:DEPT. OF MEDICINE
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5601
Practice Address - Fax:601-984-6665
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS21137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01703269Medicaid
AL130174Medicaid
MS302I114349Medicare PIN
MS302I113253Medicare PIN
AL130174Medicaid