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General NPI Number Information
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NPI Number | 1134362353
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Entity Type | Individual
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Provider Name | CHAD JAMES GRIFFITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 155 RADIO DR
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City | WOODBURY
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State | MN
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Zip | 55125-2619
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Country | US
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Telephone | 952-831-8742
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Fax |
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Provider Business Mailing Address
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Address Line | 155 RADIO DR
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City | WOODBURY
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State | MN
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Zip | 55125-2619
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 57751
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 75034-20
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 57751
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License Number State | MN
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