Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 8874 | AL |
NPI | 1174554422 |
---|---|
Provider Name | Richard C. Griffin |
First Address | Birmingham, AL 35202-2366 |
Second Address | Birmingham, AL 35211-1323 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 04/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000017781 | (05) | AL |
17781 | BCBS OF AL (01) | AL |
C74783 | (02) | AL |