MEDICARE: DR. RYAN M GRIFFITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	35.130821	OH
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1265876163
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN M GRIFFITH M.D.

Provider Business Mailing Address
First Line	:	125 E BROAD ST STE 101
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-6429
Country	:	US
Telephone Number	:	440-328-3410
Fax Number	:	440-827-5189

Provider Business Practice Location Address
First Line	:	125 E BROAD ST STE 101
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-6429
Country	:	US
Telephone Number	:	440-328-3410
Fax Number	:	440-827-5189

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2013
Last Update Date	:	02/16/2026

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