# MANDI TINE GRIFFIN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1649476680
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12237 | MT | Yes |

## Other

- **Enumeration date:** 06/26/2007
- **Last updated:** 05/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1649476680 | — | ID |
| 05 | — | 1649476680 | — | MT |