Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | DO2921 | TN |
N | 208000000X | Pediatrician | DO0000002921 | TN |
N | 208000000X | Pediatrician | OT014062 | PA |
NPI | 1205121118 |
---|---|
Provider Name | Joshua Grahe |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 15/10/2020 |