Provider Demographics
NPI:1437187978
Name:GRIFFEE, MATTHEW J (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:J
Last Name:GRIFFEE
Suffix:
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:DEPT OF ANESTHESIOLOGY 30 N 1900 E
Mailing Address - Street 2:ROOM 3 C 444
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-2501
Mailing Address - Country:US
Mailing Address - Phone:801-205-4132
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF UTAH DEPARTMENT OF
Practice Address - Street 2:30 N 1900 E ROOM 3C 444
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-2501
Practice Address - Country:US
Practice Address - Phone:801-205-4132
Practice Address - Fax:503-494-7635
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD24970207L00000X, 207R00000X
UT51980991205207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I23562Medicare UPIN