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General NPI Number Information
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NPI Number | 1609000819
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Entity Type | Individual
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Provider Name | DELOREAN Q GRIFFIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/04/2009
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 4160 JOHN R 400
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City | DETROIT
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State | MI
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Zip | 48202-2819
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Country | US
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Telephone | 313-745-7514
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Fax |
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Provider Business Mailing Address
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Address Line | 6900 ORCHARD LAKE RD STE 105
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3424
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Country | US
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Telephone | 248-557-7788
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Fax | 248-557-7789
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 4301090317
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License Number State | MI
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