Basic Information
| Provider Information | |||||||||
| NPI: | 1306972591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GROVES | ||||||||
| FirstName: | SOLEYAH | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1768 BUSINESS CENTER DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | RESTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201905359 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007629244 | ||||||||
| FaxNumber: | 7866726006 | ||||||||
| Practice Location | |||||||||
| Address1: | 3300 GALLOWS RD | ||||||||
| Address2: | |||||||||
| City: | FALLS CHURCH | ||||||||
| State: | VA | ||||||||
| PostalCode: | 220423300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7037764001 | ||||||||
| FaxNumber: | 7037767113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2007 | ||||||||
| LastUpdateDate: | 02/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 0101245183 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RP1001X | 0101245183 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RC0200X | 0101245183 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | F551-0046 | 01 | DC | CARE FIRST BLUE CROSS | OTHER | 7465920 | 01 | MD | AETNA PPO | OTHER | 909830-01 | 01 | MD | CARE FIRST BLUE CROSS | OTHER | 014246800 | 05 | MD | MEDICAID | 1599670 | 01 | MD | AETNA HMO | OTHER | 215688 | 01 | MD | JOHNS HOPKINS HEALTH CARE | OTHER | 860097 | 01 | MD | NCPPO | OTHER |