Healthcare Provider Details

I. General information

NPI: 1285838193
Provider Name (Legal Business Name): DARYL L GRIFFIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 NW GEORGIA AVE
WASHINGTON DC DC
20307
US

IV. Provider business mailing address

2951 WATERFORD CT
VIENNA VA
22181-6050
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-0039
  • Fax:
Mailing address:
  • Phone: 202-782-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number6765A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: