Individual
DR. BOTHWELL GRAVES LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1630 WOODBROOKE DR, SALISBURY, MD 21804-8501
(410) 912-6330
Mailing address
100 E CARROLL ST, SALISBURY, MD 21801-5422
(800) 749-5191
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
0101221427
VA
207T00000X
Neurological Surgery Physician
Primary
D0057234
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
581314YTQ
—
MD
Enumeration date
08/30/2006
Last updated
07/11/2019
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