Provider Demographics
NPI:1942687702
Name:GRIFFIN, PETER (NREMT-B)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:NREMT-B
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 PATTERSON AVE SW
Mailing Address - Street 2:APT 6
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-3258
Mailing Address - Country:US
Mailing Address - Phone:540-550-0166
Mailing Address - Fax:
Practice Address - Street 1:1501 PATTERSON AVE SW
Practice Address - Street 2:APT 6
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-3258
Practice Address - Country:US
Practice Address - Phone:540-550-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB201401483146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic