MEDICARE: DR. KRISTINE MARIE GRIFFIN 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	207Q00000X	Family Medicine Physician	CI-0006795	DE

General Provider Information

NPI Number	:	1871552752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTINE MARIE GRIFFIN M.D.

Provider Business Mailing Address
First Line	:	32427 LIGHTHOUSE RD
Second Line	:
City	:	SELBYVILLE
State	:	DE
Zip	:	19975-3408
Country	:	US
Telephone Number	:	302-436-9600
Fax Number	:	302-436-6260

Provider Business Practice Location Address
First Line	:	32427 LIGHTHOUSE RD
Second Line	:
City	:	SELBYVILLE
State	:	DE
Zip	:	19975-3408
Country	:	US
Telephone Number	:	302-436-9600
Fax Number	:	302-436-6260

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

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	09/30/2020

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