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NPI Code Detail

MEDICARE: TIMOTHY PATRICK GRAHAM MD

MEDICARE: TIMOTHY PATRICK GRAHAM MD
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
1207Q00000XFamily Medicine Physician35-07-9021OH

General Provider Information

NPI Number : 1609863661
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY PATRICK GRAHAM MD
Provider Business Mailing Address
First Line : 477 COOPER RD STE 300
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-8057
Country : US
Telephone Number : 380-898-8808
Fax Number : 380-898-8842
Provider Business Practice Location Address
First Line : 477 COOPER RD STE 300
Second Line :
City : WESTERVILLE
State : OH
Zip : 43081-8057
Country : US
Telephone Number : 380-898-8808
Fax Number : 380-898-8842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 04/17/2018

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Directions to “ TIMOTHY PATRICK GRAHAM MD” Practice Location

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