Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 35032190 | OH |
NPI | 1013909399 |
---|---|
Provider Name | James P Graham |
First Address | Dayton, OH 45409-2698 |
Second Address | Dayton, OH 45409-2698 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0201436 | (05) | OH |
A74526 | (02) | OH |