Healthcare Provider Details

I. General information

NPI: 1417104902
Provider Name (Legal Business Name): ALEXANDER D. GRIFFIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 QUINCY AVE
QUINCY MA
02169-8130
US

IV. Provider business mailing address

2100 DORCHESTER AVE
DORCHESTER MA
02124-5615
US

V. Phone/Fax

Practice location:
  • Phone: 617-479-0202
  • Fax: 781-882-8588
Mailing address:
  • Phone: 617-506-4910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number254736
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberTRN10875
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: