Healthcare Provider Details

I. General information

NPI: 1932489929
Provider Name (Legal Business Name): WHITNEY ALEXANDRIA GRIFFITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

INTERNAL MEDICINE MSC105550 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

7031 CASA ELENA DR NE
ALBUQUERQUE NM
87113-1153
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-6331
  • Fax:
Mailing address:
  • Phone: 505-728-1908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberRS2011-0281
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: