Graham, Lisa S

Graham, Lisa S is an individual health care provider with primary practice located at 5007 Matterhorn Drive , Duluth MN 55811-3812. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Graham, Lisa S can be contacted via phone (218) 720-3553.

Contact Information

Primary practice address
5007 Matterhorn Drive Duluth MN 55811-3812
Phone: (218) 720-3553
Fax: (218) 786-9375
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 42312 Wisconsin
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 42312-20 Wisconsin

Profile Details

NPI number 1720059603
LBN Legal business name Graham, Lisa S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Aug 23rd, 2010 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720059603 NPPES
Wisconsin MEDICAID 33333100
Wisconsin MEDICAID 837658100

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