Individual
CARL D GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01030600A
IN
2083X0100X
Occupational Medicine Physician
Primary
01030600A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000197993
ANTHEM PROVIDER NUMBER
IN
05
—
100085950
—
IN
01
—
10825175
CAQH NUMBER
IN
01
—
9397093
PHCS PID NUMBER
IN
05
—
GR15376011
—
IN
Enumeration date
03/15/2006
Last updated
07/23/2012
Update your record
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