MEDICARE: MR. DONALD SCOTT GRIFFIN PA-C

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	363AM0700X	Medical Physician Assistant	A747	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306835178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DONALD SCOTT GRIFFIN PA-C

Provider Business Mailing Address
First Line	:	1655 BERNARDIN AVE
Second Line	:	SUITE 220
City	:	COLUMBIA
State	:	SC
Zip	:	29204-2039
Country	:	US
Telephone Number	:	803-254-5038
Fax Number	:	803-376-5883

Provider Business Practice Location Address
First Line	:	1655 BERNARDIN AVE
Second Line	:	SUITE 220
City	:	COLUMBIA
State	:	SC
Zip	:	29204-2039
Country	:	US
Telephone Number	:	803-254-5038
Fax Number	:	803-376-5883

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

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	07/08/2007

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