Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD422243 | PA |
NPI | 1023088051 |
---|---|
Provider Name | Jonathan H Griner |
First Address | Ephrata, PA 17522-9550 |
Second Address | Ephrata, PA 17522-1761 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2006 |
Last Update Date | 19/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001955281 | (05) | PA |
H88277 | (02) | PA |