Individual
RONALD G GRIFKA
Active
Individual
RONALD G GRIFKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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