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NPI Code Detail

MEDICARE: DR. MARILEE CHANTAL GRISWOLD M.D.

MEDICARE:  DR. MARILEE CHANTAL GRISWOLD  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
12084P0800XPsychiatry Physician21532SC

Other Identifiers

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

General Provider Information

NPI Number : 1821068719
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARILEE CHANTAL GRISWOLD M.D.
Provider Business Mailing Address
First Line : 7901 FARROW RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-3220
Country : US
Telephone Number : 803-521-2503
Fax Number :
Provider Business Practice Location Address
First Line : 7901 FARROW RD
Second Line :
City : COLUMBIA
State : SC
Zip : 29203-3220
Country : US
Telephone Number : 803-521-2503
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2006
Last Update Date : 08/29/2013

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Directions to “ DR. MARILEE CHANTAL GRISWOLD M.D.” Practice Location

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