Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 16809 | NV |
NPI | 1013259431 |
---|---|
Provider Name | Graham S Ingalsbe |
First Address | Miami, FL 33131-2566 |
Second Address | Denver, CO 80204-4507 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2013 |
Last Update Date | 03/08/2017 |