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Individual

EMMANUEL S. GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4F-5F SUNNY ISLES PROFESSIONAL BUILDING, CHRISTIANSTED, VI 00820
(340) 719-8761
(340) 719-8764
Mailing address
PO BOX 6883, CHRISTIANSTED, VI 00823-6883
(340) 719-8761
(340) 719-8764

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
1455
VI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002-8793
MEDICARE PTAN
VI
Enumeration date
02/16/2007
Last updated
04/09/2009
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