Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD456389 | PA |
N | 208600000X | Surgeon | MD456389 | PA |
Y | 2086S0102X | Surgical Critical Care | MD456389 | PA |
N | 2086S0127X | Trauma Surgeon | MD456389 | PA |
NPI | 1235398355 |
---|---|
Provider Name | Dr. Graham G Laurence |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5176 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 11/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103130736 | (05) | PA |
PO1831813 | RAILROAD MEDICARE (01) | PA |