Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 125.064974 | IL |
N | 207X00000X | Orthopaedic Surgeon | ME144651 | FL |
Y | 2086S0105X | Surgery of the Hand | ME144651 | FL |
NPI | 1831504885 |
---|---|
Provider Name | Robert David Graham |
First Address | Atlanta, GA 30368-7345 |
Second Address | Jacksonville Beach, FL 32250-3265 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2014 |
Last Update Date | 09/12/2020 |