Healthcare Provider Details

I. General information

NPI: 1861457244
Provider Name (Legal Business Name): JOHN W GHRAMM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 W JUBAL EARLY DRIVE SUITE 240
WINCHESTER VA
22601-6319
US

IV. Provider business mailing address

440 W JUBAL EARLY DRIVE SUITE 240
WINCHESTER VA
22601-6319
US

V. Phone/Fax

Practice location:
  • Phone: 540-450-2706
  • Fax:
Mailing address:
  • Phone: 540-450-2706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number0101028049
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: