Individual
MR. ANTHONY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8101 GLEN HOLLOW DR APT D, GLEN BURNIE, MD 21061-6168
(410) 768-1385
Mailing address
8101 GLEN HOLLOW DR APT D, GLEN BURNIE, MD 21061-6168
(410) 768-1385
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R091703
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
454MI732
TRAILBLAZER
MD
Enumeration date
06/28/2005
Last updated
07/09/2007
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