MEDICARE: JAN MARIE GRIFFIN MD

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
1	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	300774-01	NY
2	207RC0000X	Cardiovascular Disease Physician	300774-01	NY
3	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	87158	SC
4	207R00000X	Internal Medicine Physician	300774-01	NY

General Provider Information

NPI Number	:	1659632701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAN MARIE GRIFFIN MD

Provider Business Mailing Address
First Line	:	PO BOX 421718
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29442-4203
Country	:	US
Telephone Number	:	843-527-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-0001
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	01/30/2026

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