Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 01063607A | IN |
Y | 207SG0201X | Clinical Genetics (M.D.) | ME128186 | FL |
NPI | 1437152832 |
---|---|
Provider Name | Christopher B Griffith |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-3803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017769400 | (05) | FL |
200936950 | (05) | IN |
HGGC8 | BLUE CROSS BLUE SHIELD (01) | FL |