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Individual
MR. MICHAEL BRENT GRAHAM
Active
Individual
MR. MICHAEL BRENT GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MPA.2870PA
SC
363AS0400X
Surgical Physician Assistant
Primary
2870
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/25/2017
Last updated
02/10/2026
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