Individual
MARK NUTTER GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 MON HEALTH MEDICAL PARK DR STE 1102, MORGANTOWN, WV 26505
(304) 598-2801
(304) 599-6463
Mailing address
1225 S. BROADWAY, SUITE 201, LEXINGTON, KY 40504
(859) 258-4568
(859) 258-4698
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25206
KY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
28054
WV
207RP1001X
Pulmonary Disease Physician
25206
KY
207RP1001X
Pulmonary Disease Physician
Primary
28054
WV
207RP1001X
Pulmonary Disease Physician
65883
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
ASC MEDICAID GROUP
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64089907
—
KY
01
—
ASC1019
ASC MEDICARE GROUP
KY
01
—
CB5773
RR MEDICARE GROUP
KY
01
—
P00179690
RR MEDICARE PIN
KY
Enumeration date
07/11/2006
Last updated
08/15/2018
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