Individual
LOUIS B GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20304 TIMBERLAKE RD, LYNCHBURG, VA 24502-7222
(434) 237-6471
(434) 237-8810
Mailing address
20304 TIMBERLAKE RD, LYNCHBURG, VA 24502-7222
(434) 237-6471
(434) 237-8810
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101027376
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005601673
—
VA
01
—
066024
ANTHEM
—
01
—
080131689
MEDICARE RAILROAD
—
Enumeration date
11/17/2005
Last updated
08/13/2013
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