Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 35-070230 | OH |
NPI | 1821185596 |
---|---|
Provider Name | Dr. Thomas Brent Graham |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 15/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2058955 | (05) | OH |
H42546 | (02) | OH |