Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Individual
MR. GRAHAM R WIDRICK
Active
Individual
MR. GRAHAM R WIDRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62 028214
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5142742
AETNA
NC
01
—
C775Q
BCBS
NC
Enumeration date
11/10/2005
Last updated
09/17/2009
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