Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RANDALL PAUL GROVE, PA
ActivePhysician Assistant · MYRTLE BEACH, SC
Registration Details
- NPI Number
- 1619969250
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 19, 2005 (20.685496322248 yrs)
- Last Updated
- Oct 19, 2017
- License
-
MA001516L (PA)
Practice Information
- Address
-
1101 JOHNSON AVEMYRTLE BEACH, SC, 295771893Browse SC providers · Browse ZIP 29577
- Phone
- 8434770177
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in MYRTLE BEACH, SC
| Name | Credential | NPI |
|---|---|---|
| MRS. ASHLEY SMITH WILSON | P.A. | 1487655106 |
| MRS. ROBERTA RAE ALSWORTH | PA-C | 1790775385 |
| MRS. TRACY REYMORE BLACK | PA-C | 1033181193 |
| JOSEPH K BETHLE | PAC | 1235195850 |
| HISHAM IBRAHIM BASSIOUNI | PAC | 1205883105 |
| MR. JEFFREY THOMAS WEEDEN | P.A. | 1972539286 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.