Individual
MR. DOUGLAS E GRAHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1778 ALA MOANA BLVD, UL-5, HONOLULU, HI 96815-1605
(808) 955-5553
(808) 955-5575
Mailing address
1860 ALA MOANA BLVD, APARTMENT 709, HONOLULU, HI 96815-1632
(808) 955-5553
(808) 955-5575
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
AMD-181
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000242867
BC/BS OF HAWAII
HI
05
—
05715502
—
HI
Enumeration date
05/19/2006
Last updated
07/09/2007
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