Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD.17559 | AL |
NPI | 1043248420 |
---|---|
Provider Name | George C Graves |
First Address | Foley, AL 36535-2282 |
Second Address | Foley, AL 36535-2282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 13/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00116982 | (05) | MS |
03983377 | (05) | MS |
105309800 | (05) | FL |
230944 | (05) | AL |
233632 | (05) | AL |
511-83513 | BCBS-AL (01) | AL |
F63512 | (02) | AL |