Individual
DR. M ALLAN GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 EAST COLLEGE AVE, BLOOMINGTON, IL 61701
(309) 664-3000
Mailing address
602 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-3311
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036051930
IL
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
036051930
IL
208D00000X
General Practice Physician
036051930
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0533210001
DMERC
IL
01
—
P00371726
RAILROAD
IL
Enumeration date
07/03/2006
Last updated
04/02/2010
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