Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35.066570 | OH |
N | 207X00000X | Orthopaedic Surgeon | D0055971 | MD |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 287705 | NY |
NPI | 1295799666 |
---|---|
Provider Name | Dr. Thomas J. Graham |
First Address | Miamisburg, OH 45342-6115 |
Second Address | Kettering, OH 45429-1285 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 10/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
331950400 | (05) | MD |
903A | CAREFIRST MARYLAND (01) | MD |
DC8030 | RAILROAD MEDICARE (01) | MD |
DE5302 | RAILROAD MEDICARE (01) | MD |
F55795 | (02) | |
J848 | CAREFIRST DC (01) | MD |