Healthcare Provider Details

I. General information

NPI: 1265876163
Provider Name (Legal Business Name): RYAN M GRIFFITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E BROAD ST STE 101
ELYRIA OH
44035-6429
US

IV. Provider business mailing address

125 E BROAD ST STE 101
ELYRIA OH
44035-6429
US

V. Phone/Fax

Practice location:
  • Phone: 440-328-3410
  • Fax: 440-827-5189
Mailing address:
  • Phone: 440-328-3410
  • Fax: 440-827-5189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.130821
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: