Individual
MICHELLE L GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1781 COUNTRYSIDE DR, LANCASTER, OH 43130-4056
(740) 687-8600
(740) 653-8236
Mailing address
1781 COUNTRYSIDE DR, LANCASTER, OH 43130-4056
(740) 687-8600
(740) 653-8236
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35076652
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000317283
ANTHEM
—
05
—
2190454
—
OH
01
—
510450201030
CARESOURCE
—
01
—
P00085750
RAILROAD MEDICARE
—
Enumeration date
12/20/2005
Last updated
06/25/2008
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