Provider Demographics
NPI:1437141439
Name:GRIFFITH, MICHAEL STEPHEN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:STEPHEN
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5141
Mailing Address - Country:US
Mailing Address - Phone:843-618-3990
Mailing Address - Fax:
Practice Address - Street 1:510 GRAHAM ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-5141
Practice Address - Country:US
Practice Address - Phone:843-618-3990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN1757367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered