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General NPI Number Information
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NPI Number | 1992977110
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Entity Type | Organization
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Legal Business Name | OBGYN BILLING
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 03/27/2008
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Provider Practice Location Address
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Address Line | 4720 S I 10 SERVICE RD W STE 104
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City | METAIRIE
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State | LA
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Zip | 70001-7403
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Country | US
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Telephone | 504-457-0299
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Fax |
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Provider Business Mailing Address
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Address Line | 4720 S I 10 SERVICE RD W STE 104
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City | METAIRIE
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State | LA
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Zip | 70001-7403
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Country | US
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Telephone | 504-457-0299
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL E GRAHAM
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Credential | MD
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Telephone | 504-457-0299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | L018221
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License Number State | LA
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