Individual
MR. GREG GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 357-9881
Mailing address
555 N ARLINGTON AVE, RENO, NV 89503-4723
(775) 786-3040
(775) 786-1887
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1511
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100538896
—
NV
01
—
12671459
CAQH
—
Enumeration date
02/14/2014
Last updated
04/28/2022
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