Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 23742 | MN |
NPI | 1154344232 |
---|---|
Provider Name | Dr. David James Griffin |
First Address | Minneapolis, MN 55417-2309 |
Second Address | Minneapolis, MN 55417-2309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 13/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D81628 | (02) | MN |