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NPI Code Detail

MEDICARE: DR. EDNA GRIFFENHAGEN M.D.

MEDICARE: DR. EDNA GRIFFENHAGEN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician0101225421VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326017823
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDNA GRIFFENHAGEN M.D.
Provider Business Mailing Address
First Line : PO BOX 15539
Second Line :
City : RICHMOND
State : VA
Zip : 23227-5539
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 150 KINGSLEY LN
Second Line :
City : NORFOLK
State : VA
Zip : 23505-4602
Country : US
Telephone Number : 804-266-3530
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 07/08/2007

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