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:
Health care specialties
| Specialty | Code | License # | 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 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1568449254 | NPPES |
| Florida | MEDICAID | 266131400 |
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