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NPI 1952332405

NPI 1952332405 : DONNA F GRIFFIN PAC : RALEIGH, NC

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General NPI Number Information
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    NPI Number           |    1952332405
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    Entity Type          |    Individual 
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    Provider Name        |    DONNA F GRIFFIN PAC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/05/2006
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    Last Update Date     |    12/13/2010
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Provider Practice Location Address
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    Address Line         |    7320 SIX FORKS RD STE 260
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27615
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    Country              |    US
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    Telephone            |    919-846-9292
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    Fax                  |    919-848-3638
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Provider Business Mailing Address
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    Address Line         |    7320 SIX FORKS RD STE 260
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    City                 |    RALEIGH
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    State                |    NC
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    Zip                  |    27615
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    Country              |    US
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    Telephone            |    919-846-9292
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    Fax                  |    919-848-3638
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    102161
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    License Number State |    NC
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