Individual
DANIEL GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
30 SHREWSBURY PLZ, SHREWSBURY, NJ 07702-4322
(732) 542-0002
(732) 542-2992
Mailing address
PO BOX 8519, RED BANK, NJ 07701-8519
(732) 460-9840
(732) 460-9848
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB10197200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2015
Last updated
06/07/2018
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