Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 09042 | WV |
Y | 208600000X | Surgeon | 09042 | WV |
NPI | 1013243682 |
---|---|
Provider Name | Dr. Frank Cantrell Griswold |
First Address | Morgantown, WV 26505-2442 |
Second Address | Morgantown, WV 26505-2442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2009 |
Last Update Date | 02/11/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09042 | WV MEDICAL LICENSE (01) | WV |