Graham, Michelle L

Graham, Michelle L is an individual health care provider with primary practice located at 2055 Kimball Ave Suite 101, Waterloo IA 50702-5047. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Graham, Michelle L can be contacted via phone (319) 272-2112.

Contact Information

Primary practice address
2055 Kimball Ave Suite 101 Waterloo IA 50702-5047
Phone: (319) 272-2112
Fax: (319) 272-2107
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 34189 Iowa

Profile Details

NPI number 1295722106
LBN Legal business name Graham, Michelle L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Mar 7th, 2023 - about 2 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 1295722106 NPPES
Iowa MEDICAID I245332

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