Individual
RONALD G GRIFKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301405835
MI
2080P0202X
Pediatric Cardiology Physician
Primary
4301405835
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0D16078136
MEDICARE PTAN
MI
01
—
1558407189
GROUP NPI
MI
01
—
350D176310
BCBSM
MI
05
—
4793463
—
MI
01
—
D16256055
GROUP #
MI
Enumeration date
01/20/2006
Last updated
10/22/2019
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