Individual
GRAHAM HARVEY COSPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 RANDOLPH RD., STE. 210, CHARLOTTE, NC 28207-1106
(704) 370-0223
(704) 370-0799
Mailing address
1900 RANDOLPH RD., STE. 210, CHARLOTTE, NC 28207-1106
(704) 370-0223
(704) 370-0799
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
2009-00994
NC
2086S0120X
Pediatric Surgery Physician
E-5149
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2075144
MEDICARE
—
01
—
5912425
MEDICAID
NC
01
—
N94009
MEDICAID
SC
Enumeration date
05/18/2007
Last updated
07/29/2010
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