Provider Demographics
NPI:1184251852
Name:PLATTNER, GRIFFIN (MD)
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:
Last Name:PLATTNER
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 1:4942 W PINE BLVD APT 3E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1419
Mailing Address - Country:US
Mailing Address - Phone:239-938-6668
Mailing Address - Fax:
Practice Address - Street 1:55 FRUIT ST # 7730
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2696
Practice Address - Country:US
Practice Address - Phone:239-938-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program