Individual
MS. DEANNA GRIFKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11900 E 12 MILE RD, SUITE # 111, WARREN, MI 48093-3400
(586) 573-5300
(586) 573-5304
Mailing address
11900 E 12 MILE RD, SUITE # 111, WARREN, MI 48093-3400
(586) 573-5300
(586) 573-5304
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004096
MI
363A00000X
Physician Assistant
PA9103122
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292314900
—
FL
05
—
29Z314900
—
FL
01
—
M57830007
MEDICARE NUMBER
MI
Enumeration date
06/01/2006
Last updated
10/10/2012
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