Graham, Mark G.

Graham, Mark G. is an individual health care provider with primary practice located at 2301 S Broad St Suite 205, Philadelphia PA 19148-3542. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Graham, Mark G. can be contacted via phone (215) 551-8660.

Contact Information

Primary practice address
2301 S Broad St Suite 205 Philadelphia PA 19148-3542
Phone: (215) 551-8660
Fax: (215) 551-9247
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD-022223-E Pennsylvania
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X MD-022223-E Pennsylvania

Profile Details

NPI number 1245258482
LBN Legal business name Graham, Mark G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 17th, 2006
Last updated Mar 24th, 2015 - about 9 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 1245258482 NPPES
Pennsylvania MEDICAID 000810360
Pennsylvania MEDICAID 7569106

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