Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 34215 | CO |
NPI | 1891822854 |
---|---|
Provider Name | Allan W Graham |
First Address | Denver, CO 80247-1314 |
Second Address | Denver, CO 80247-1314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
008372 | KAISER-COMMERCIAL NUMBER (01) | |
01342153 | (05) | CO |
D03293 | (02) | CO |