Organization
MICHIANA ORTHOPAEDICS AND SPORTS MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD E GRIFFIN JR. M.D. (PRESIDENT)
(269) 651-9470
Entity
Organization
Contact information
Practice address
600 S LAKEVIEW AVE, SUITE 105, STURGIS, MI 49091-2371
(269) 651-9470
(269) 651-3771
Mailing address
600 S LAKEVIEW AVE, SUITE 105, STURGIS, MI 49091-2371
(269) 651-9470
(269) 651-3771
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301077154
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0750055
BCBSM
MI
05
—
4243455
—
MI
Enumeration date
03/11/2008
Last updated
03/11/2008
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