Organization
SUSAN B GRAHAM INC
Active
Organization
SUSAN B GRAHAM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN B GRAHAM MD (PRESIDENT)
(505) 884-7059
Entity
Organization
Contact information
Practice address
835 SPRUCE ST, ESPANOLA, NM 87532-3455
(505) 884-7059
Mailing address
835 SPRUCE ST, ESPANOLA, NM 87532-3455
(505) 884-7059
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
86-237
NM
Other
Enumeration date
10/07/2008
Last updated
10/07/2008
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