Provider Demographics
NPI:1871625178
Name:GROVES, ALLEN B (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:B
Last Name:GROVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:701 PRINCETON AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1303
Practice Address - Country:US
Practice Address - Phone:205-783-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL254912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009923066Medicaid
AL051541117OtherBLUE CROSS
AL511-56297OtherBLUE CROSS
AL122538Medicaid
AL511-09728OtherBLUE CROSS
AL009942923Medicaid
AL009942941Medicaid
AL051541118OtherBLUE CROSS
AL009942293Medicaid
AL168392Medicaid
AL515-94507OtherBLUE CROSS
AL051540533OtherBLUE CROSS
AL051541119OtherBLUE CROSS
AL105581Medicaid
AL515-94507OtherBLUE CROSS
AL009942293Medicaid
AL051554626Medicare PIN
AL051541118OtherBLUE CROSS
AL168392Medicaid