Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 35057460 | OH |
N | 208600000X | Surgeon | 35057460 | OH |
Y | 2086X0206X | Surgical Oncologist | 73694 | GA |
NPI | 1326149857 |
---|---|
Provider Name | Cathy Graham |
First Address | Atlanta, GA 30342-1764 |
Second Address | Atlanta, GA 30342-1764 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 04/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F23626 | (02) |