Provider Demographics
NPI:1134438310
Name:ROBERT MICHAEL GRIFE ENTERPRISES, LLC
Entity type:Organization
Organization Name:ROBERT MICHAEL GRIFE ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GRIFE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-509-3445
Mailing Address - Street 1:23 N DELSEA DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08312-1637
Mailing Address - Country:US
Mailing Address - Phone:856-423-7000
Mailing Address - Fax:856-423-0823
Practice Address - Street 1:401 COUNTRY CLUB CT
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3310
Practice Address - Country:US
Practice Address - Phone:609-350-6680
Practice Address - Fax:609-317-4868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-05
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty