Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 757 | NE |
NPI | 1003054016 |
---|---|
Provider Name | Dr. Brendan Daugharty Griffis |
First Address | Washington, DC 20422-0001 |
Second Address | Fort Leonard Wood, MO 65473-8952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2009 |
Last Update Date | 31/03/2020 |