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General NPI Number Information
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NPI Number | 1548391568
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Entity Type | Organization
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Legal Business Name | GRAHAM MEDICAL SERVICES PLLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 800 CHATHAM MEDICAL PARK
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City | ELKIN
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State | NC
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Zip | 28621-2484
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Country | US
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Telephone | 336-527-1033
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24187
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City | WINSTON SALEM
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State | NC
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Zip | 27114-4187
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Country | US
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Telephone | 336-527-1033
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | WILLIAM A GRAHAM IV
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Credential | MD
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Telephone | 336-527-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 98-00878
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License Number State | NC
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