Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 4301057598 | MI |
NPI | 1225052186 |
---|---|
Provider Name | Dr. Joseph M Mcgraw |
First Address | Traverse City, MI 49684-8965 |
Second Address | Traverse City, MI 49684-8965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 10/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103105024 | (05) | MI |
E44276 | (02) |