Provider Demographics
NPI:1801093133
Name:GRIFFIN, PHILIP C (AUD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:C
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 CREEDMOOR ROAD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612
Mailing Address - Country:US
Mailing Address - Phone:919-256-2898
Mailing Address - Fax:
Practice Address - Street 1:4701 CREEDMOOR ROAD
Practice Address - Street 2:SUITE 111
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612
Practice Address - Country:US
Practice Address - Phone:919-256-2898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7768231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBCBS NCOther156 AJ
NCBCBS NCOther156 AJ