Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 74237 | GA |
NPI | 1063597706 |
---|---|
Provider Name | Douglas Graham |
First Address | Atlanta, GA 30322-1060 |
Second Address | Atlanta, GA 30322-1060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 25/06/2021 |