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General NPI Number Information
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NPI Number | 1003896580
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Entity Type | Individual
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Provider Name | DONNA MELISSA GRAHAM M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 06/29/2018
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Provider Practice Location Address
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Address Line | 500 S UNIVERSITY AVE SUITE 215
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-420-1085
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Fax | 501-420-1457
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Provider Business Mailing Address
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Address Line | 500 S UNIVERSITY AVE SUITE 215
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5302
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Country | US
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Telephone | 501-420-1085
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Fax | 501-420-1457
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | E-1260
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License Number State | AR
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