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Organization

DAVID GRAHAM M.D., LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CASSIE J WALTZ (PROVIDER ENROLLMENT CONSULTANT)
(615) 567-7869
Entity
Organization

Contact information

Practice address
319 HOSPITAL DR, STE 208, MARTINSVILLE, VA 24112-1929
(276) 656-2103
Mailing address
319 HOSPITAL DR, STE 208, MARTINSVILLE, VA 24112-1929
(276) 656-2103

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Enumeration date
12/02/2016
Last updated
12/02/2016
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