Provider Demographics
NPI:1871552752
Name:GRIFFIN, KRISTINE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTINE
Middle Name:MARIE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:32427 LIGHTHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SELBYVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19975-3408
Mailing Address - Country:US
Mailing Address - Phone:302-436-9600
Mailing Address - Fax:302-436-6260
Practice Address - Street 1:32427 LIGHTHOUSE RD
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-3408
Practice Address - Country:US
Practice Address - Phone:302-436-9600
Practice Address - Fax:302-436-6260
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DECI-0006795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG02341Medicare PIN
MD275PMedicare PIN