Provider Demographics
NPI:1285632166
Name:GRIFFITH, CORINNE L (MD)
Entity Type:Individual
Prefix:
First Name:CORINNE
Middle Name:L
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 ATRIUM DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6673
Mailing Address - Country:US
Mailing Address - Phone:919-232-0020
Mailing Address - Fax:
Practice Address - Street 1:2417 ATRIUM DR
Practice Address - Street 2:SUITE 201
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6673
Practice Address - Country:US
Practice Address - Phone:919-232-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9501260207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2246631AMedicare ID - Type Unspecified