Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 59398 | MN |
Y | 207T00000X | Neurosurgeon | 62549 | AZ |
NPI | 1003222738 |
---|---|
Provider Name | Dr. Christopher Salvatore Graffeo |
First Address | Phoenix, AZ 85013-4434 |
Second Address | Phoenix, AZ 85013-4434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2014 |
Last Update Date | 28/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
092288 | (05) | AZ |