MEDICARE: JASON A GRAHAME PA-C

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
1	363AM0700X	Medical Physician Assistant	0110001707	VA
2	363AS0400X	Surgical Physician Assistant	01110001707	VA

General Provider Information

NPI Number	:	1275563850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON A GRAHAME PA-C

Provider Business Mailing Address
First Line	:	5501 GREENWICH RD
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6540
Country	:	US
Telephone Number	:	757-502-8570
Fax Number	:	757-490-4878

Provider Business Practice Location Address
First Line	:	5501 GREENWICH RD
Second Line	:	SUITE 200
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-6540
Country	:	US
Telephone Number	:	757-502-8570
Fax Number	:	757-490-4878

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	09/11/2025

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Directions to “ JASON A GRAHAME PA-C” Practice Location

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