Individual
DR. TERRY S GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N MAYFAIR RD, SUITE 220, WAUWATOSA, WI 53226-1409
(414) 475-9101
(414) 475-9203
Mailing address
8104 BROOKSIDE PL, WAUWATOSA, WI 53213-3318
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30249900
—
WI
Enumeration date
01/10/2007
Last updated
07/08/2007
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