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NPI Code Detail

MEDICARE: MR. THOMAS GRAVES

MEDICARE:  MR. THOMAS  GRAVES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1073133856
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS GRAVES
Provider Business Mailing Address
First Line : 7301 MASTERS DR
Second Line :
City : POTOMAC
State : MD
Zip : 20854-3850
Country : US
Telephone Number : 570-768-8084
Fax Number :
Provider Business Practice Location Address
First Line : 2111 BALDWIN AVE STE 3
Second Line :
City : CROFTON
State : MD
Zip : 21114-2419
Country : US
Telephone Number : 410-697-3527
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2020
Last Update Date : 04/21/2020

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Directions to “ MR. THOMAS GRAVES ” Practice Location

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