Provider Demographics
NPI:1326169160
Name:GRIFFIN, GARRETT R (MD)
Entity Type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:R
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2080 WOODWINDS DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2523
Mailing Address - Country:US
Mailing Address - Phone:651-702-0750
Mailing Address - Fax:651-645-6166
Practice Address - Street 1:2080 WOODWINDS DR
Practice Address - Street 2:SUITE 120
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:703-628-6424
Practice Address - Fax:651-645-6166
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2018-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN57227207YS0123X, 207YS0123X
MN107007207Y00000X
MI4301087865390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program