Graham, Gary Robert
Graham, Gary Robert is an individual health care provider with primary practice located at 2776 Enterprise Rd # 100 , Orange City FL 32763-8316. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Graham, Gary Robert can be contacted via phone (386) 774-1223.Contact Information
Primary practice address
2776 Enterprise Rd # 100
Orange City FL 32763-8316
Phone: (386) 774-1223
Fax: (386) 774-4658
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | ME68452 | Florida |
Profile Details
NPI number | 1538160692 |
---|---|
LBN Legal business name | Graham, Gary Robert |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 10th, 2005 |
Last updated | Dec 13th, 2017 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538160692 | NPPES |
Florida | MEDICAID | 379101700 |
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