Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 57751 | MN |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 57751 | MN |
NPI | 1134362353 |
---|---|
Provider Name | Dr. Chad James Griffith |
First Address | Woodbury, MN 55125-2619 |
Second Address | Woodbury, MN 55125-2619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2009 |
Last Update Date | 05/12/2019 |