Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 2011-00292 | NC |
NPI | 1639142268 |
---|---|
Provider Name | Thomas Griffin |
First Address | Charlotte, NC 28219-9305 |
Second Address | Charlotte, NC 28203-5866 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 20/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H10431 | (02) |