Provider Demographics
NPI:1598953705
Name:GRIFFIN, MEREDITH MCLAIN (PA)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:MCLAIN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2093 HENRY TECKLENBURG DR STE 300E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5743
Practice Address - Country:US
Practice Address - Phone:843-724-2011
Practice Address - Fax:843-606-7991
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2020-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC1255363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1069PAMedicaid
SCAA24189223Medicare PIN