Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 63303 | WI |
N | 207RP1001X | Pulmonary Disease | 63303 | WI |
NPI | 1013035310 |
---|---|
Provider Name | Brian David Griffith |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2007 |
Last Update Date | 20/01/2021 |