Individual
DR. SAMUEL LYLE GRAHAM III
Active
Individual
DR. SAMUEL LYLE GRAHAM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18158
KY
207RP1001X
Pulmonary Disease Physician
18158
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1061538
PASSPORT
KY
01
—
538148
BCBS
KY
05
—
64181589
—
KY
Enumeration date
12/31/2006
Last updated
06/20/2008
Update your record
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