Grooms, Mary Clarke

Grooms, Mary Clarke is an individual health care provider with primary practice located at 6440 W Newberry Rd Ste 402, Gainesville FL 32605-4381. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Grooms, Mary Clarke can be contacted via phone (352) 332-5500.

Contact Information

Primary practice address
6440 W Newberry Rd Ste 402 Gainesville FL 32605-4381
Phone: (352) 332-5500
Fax: (352) 332-5506
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X ME84259 Florida
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME84259 Florida

Profile Details

NPI number 1568449254
LBN Legal business name Grooms, Mary Clarke
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 23rd, 2005
Last updated Dec 9th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568449254 NPPES
Florida MEDICAID 266131400

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