Provider Demographics
NPI:1144417643
Name:GRIFFIN, DEBORAH EVANS (MTASCP 92105)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:EVANS
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MTASCP 92105
Other - Prefix:MRS
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:383 MIRIAM DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-9169
Mailing Address - Country:US
Mailing Address - Phone:336-764-4442
Mailing Address - Fax:
Practice Address - Street 1:383 MIRIAM DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-9169
Practice Address - Country:US
Practice Address - Phone:336-764-4442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist