# THEODORE K GRAHAM MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316256472
- **Authorized official:** DR. THEODORE K GRAHAM MD (PRESIDENT)
- **Authorized official phone:** (248) 547-9292

## Contact information

- **Practice address:** 12900 W 9 MILE RD, OAK PARK, MI 48237-2990
- **Practice address phone:** (248) 547-9292
- **Practice address fax:** (248) 547-2985
- **Mailing address:** PO BOX 3337, SOUTHFIELD, MI 48037-3337
- **Mailing address phone:** (248) 547-9292
- **Mailing address fax:** (248) 547-2985

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 4301050455 | MI | Yes |

## Other

- **Enumeration date:** 10/06/2010
- **Last updated:** 10/06/2010