Individual
JEFFREY M GRAVES
Active
Individual
JEFFREY M GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101034376
VA
207R00000X
Internal Medicine Physician
20427
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000894844
BLUE CROSS BLUE SHIELD
WV
01
—
P00013537
RAILROAD PTAN
WV
01
—
P00013537
RAILROAD MEDICARE
—
Enumeration date
06/03/2006
Last updated
01/03/2012
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