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NPI Code Detail

MEDICARE: GRIFFIN EDWARD LUDWIG MD

MEDICARE: GRIFFIN EDWARD LUDWIG 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
12085R0202XDiagnostic Radiology PhysicianMD495825PA
22085R0202XDiagnostic Radiology Physician125075920IL
3207R00000XInternal Medicine Physician125075920IL

General Provider Information

NPI Number : 1487276036
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRIFFIN EDWARD LUDWIG MD
Provider Business Mailing Address
First Line : 3509 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-4105
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3401 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5103
Country : US
Telephone Number : 215-707-7237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2020
Last Update Date : 06/15/2026

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