MEDICARE: WILLIAM C GRAFFEO 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
1	207P00000X	Emergency Medicine Physician	35045289	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790792042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM C GRAFFEO MD

Provider Business Mailing Address
First Line	:	2800 MAPLE AVE
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-1716
Country	:	US
Telephone Number	:	740-586-6821
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 MAPLE AVE
Second Line	:
City	:	ZANESVILLE
State	:	OH
Zip	:	43701-1716
Country	:	US
Telephone Number	:	740-586-6821
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	08/12/2011

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