Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2301008167 | MI |
Y | 111NR0200X | Radiology | 2301008167 | MI |
Y | 213ER0200X | Radiology | 2301008167 | MI |
NPI | 1750330494 |
---|---|
Provider Name | Dr. Nicholas Spencer Griffiths |
First Address | Allen Park, MI 48101-1902 |
Second Address | Allen Park, MI 48101-1902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 08/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4679057 | (05) | MI |
U90072 | (02) | MI |