Leroy A Griffin

Individual provider Active NPI Driver · Myrtle Beach, SC

NPI 1760337232 · NPPES record last updated Mar 4, 2026

Key facts

NPI
1760337232
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
102641107 (SC)
Practice address
131 Vaught PL Unit 101
Myrtle Beach, SC 29588-3716
Phone
(843) 457-0529
NPI assigned
Mar 2, 2026
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
102641107SCMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver
Group: 193400000X SINGLE SPECIALTY GROUP
172A00000X 102641107 SC Yes

Addresses

Primary practice location

131 Vaught PL Unit 101
Myrtle Beach, SC 29588-3716

Mailing address

131 Vaught PL Unit 101
Myrtle Beach, SC 29588-3716
Phone (843) 457-0529

Other providers in Myrtle Beach, SC

All providers in Myrtle Beach, SC · Driver in South Carolina

Sources for this page

Verify at the official NPI Registry.