1346612306 NPI number — DR. F. NDIDI UCHE GRIFFIN-MYERS IV F.N.P.

Table of content: DR. F. NDIDI UCHE GRIFFIN-MYERS IV F.N.P. (NPI 1346612306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346612306 NPI number — DR. F. NDIDI UCHE GRIFFIN-MYERS IV F.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN-MYERS
Provider First Name:
F. NDIDI
Provider Middle Name:
UCHE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
IV
Provider Credential Text:
F.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRIFFIN
Provider Other First Name:
F. NDIDI
Provider Other Middle Name:
UCHE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1346612306
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9759 N WILLEY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93720-5416
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-930-2496
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4441 E KINGS CANYON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93702-3604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-600-4099
Provider Business Practice Location Address Fax Number:
559-455-4743
Provider Enumeration Date:
10/29/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  3238 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0808X , with the licence number: 320766 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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