# DR. TANITH M. GRAHAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790752640
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 09591 | MS | Yes |
| 207L00000X | Anesthesiology Physician | MD13201 | OR | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | MD13201 | OR | — |

## Other

- **Enumeration date:** 02/28/2006
- **Last updated:** 01/18/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02121230 | — | MS |
| 01 | — | 050032614 | RR MEDICARE | OR |
| 05 | — | 1037381 | — | WA |
| 05 | — | 117006 | — | OR |
| 05 | — | 7394381-00 | — | MN |