Individual
TAMMY O GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
601 JOHN ST, SUITE E352, KALAMAZOO, MI 49007-5341
(269) 341-8986
(269) 341-6236
Mailing address
601 JOHN ST, SUITE E352, KALAMAZOO, MI 49007-5341
(269) 341-8986
(269) 341-6236
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
5101009445
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3041221
—
MI
Enumeration date
01/19/2006
Last updated
11/27/2023
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