Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 13867 | MI |
Y | 213EG0000X | General Practice | 13867 | MI |
NPI | 1003091919 |
---|---|
Provider Name | Dr. Susan Tapert Griffin |
First Address | Harper Woods, MI 48225-1417 |
Second Address | Harper Woods, MI 48225-1417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2008 |
Last Update Date | 09/01/2008 |