Doctor Name: | DR. M ALLAN GRIFFITH |
NPI Number: | 1801826235 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036051930 |
Business Practice Address: | 1701 East College Ave Bloomington, IL - 61701 |
Business Phone Number: | 3096643000 |
Business Fax Number: | |
Mailing Address: | 602 W University Ave, URBANA |
State: | IL |
Postal Code: | 618012530 |
Phone Number: | 2173833311 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 04/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036051930 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |