Provider Demographics
NPI:1407958879
Name:GRIFFITH, FREDERICK PHILLIP III (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:PHILLIP
Last Name:GRIFFITH
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:PO BOX 995
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20118-0995
Mailing Address - Country:US
Mailing Address - Phone:540-687-5563
Mailing Address - Fax:
Practice Address - Street 1:204 E FEDERAL ST.
Practice Address - Street 2:SUITE 1
Practice Address - City:MIDDLEBURG
Practice Address - State:VA
Practice Address - Zip Code:20117
Practice Address - Country:US
Practice Address - Phone:540-687-5563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101032456207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB05373Medicare UPIN
VA5697701Medicare ID - Type Unspecified