MEDICARE: MATTHEW J GRIFFEE MD

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	207L00000X	Anesthesiology Physician	MD24970	OR
2	207R00000X	Internal Medicine Physician	MD24970	OR
3	207L00000X	Anesthesiology Physician	51980991205	UT

General Provider Information

NPI Number	:	1437187978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW J GRIFFEE MD

Provider Business Mailing Address
First Line	:	DEPT OF ANESTHESIOLOGY 30 N 1900 E
Second Line	:	ROOM 3 C 444
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-2501
Country	:	US
Telephone Number	:	801-205-4132
Fax Number	:

Provider Business Practice Location Address
First Line	:	UNIVERSITY OF UTAH DEPARTMENT OF
Second Line	:	30 N 1900 E ROOM 3C 444
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-2501
Country	:	US
Telephone Number	:	801-205-4132
Fax Number	:	503-494-7635

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

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	11/02/2021

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