Provider Demographics
NPI:1083640080
Name:GRIFFEN, DANIEL LEONARD III (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEONARD
Last Name:GRIFFEN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15225 SHADY GROVE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3254
Mailing Address - Country:US
Mailing Address - Phone:301-670-3000
Mailing Address - Fax:301-924-0186
Practice Address - Street 1:15225 SHADY GROVE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3254
Practice Address - Country:US
Practice Address - Phone:301-670-3000
Practice Address - Fax:301-924-0186
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0042110207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD781811400Medicaid
MDF06283Medicare UPIN
MD781811400Medicaid