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General NPI Number Information
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NPI Number | 1043473739
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Entity Type | Individual
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Provider Name | GRAHAM WALTER WARREN MD
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Gender | Male
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 800 ROSE ST STE C114D
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City | LEXINGTON
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State | KY
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Zip | 40536-8908
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Country | US
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Telephone | 859-257-7618
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Fax | 859-257-4060
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Provider Business Mailing Address
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Address Line | PO BOX 751461
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City | CHARLOTTE
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State | NC
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Zip | 28275-1461
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Country | US
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Telephone | 843-792-6200
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Fax |
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 35282
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 2085R0203X
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Taxonomy Name | Therapeutic Radiology Physician
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License Number | 253883
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 60454
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License Number State | KY
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