Individual
MATTHEW TIMOTHY GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
203 MILLS AVE, GREENVILLE, SC 29605-4019
(864) 271-1844
Mailing address
203 MILLS AVE, GREENVILLE, SC 29605-4019
(864) 271-1844
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
24329
SC
2085R0202X
Diagnostic Radiology Physician
MD27447
TN
2085R0204X
Vascular & Interventional Radiology Physician
24329
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300110847
RR MEDICARE
—
01
—
3146921
BCBS
—
05
—
3852107
—
TN
05
—
3852108
—
TN
05
—
3852109
—
TN
01
—
4102717
BCBS
—
01
—
P00264044
RR MEDICARE
—
Enumeration date
03/07/2006
Last updated
06/26/2025
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