Provider Demographics
NPI:1275828931
Name:GRIFFIN, ERIC SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:SCOTT
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8150 PERRY HWY STE 201
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5200
Mailing Address - Country:US
Mailing Address - Phone:724-741-0044
Mailing Address - Fax:412-369-9566
Practice Address - Street 1:1140 PERRY HWY
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2160
Practice Address - Country:US
Practice Address - Phone:412-364-4402
Practice Address - Fax:412-364-3850
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102993548-0001Medicaid
PA102993548-0003Medicaid