Organization
LAKE PLASTIC AND HAND SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GRAHAM MD (OWNER/PHYSICIAN)
(407) 453-1036
Entity
Organization
Contact information
Practice address
6532 ANTHONY DR, VICTOR, NY 14564-1403
(407) 453-1036
Mailing address
2018 HOUNZ LN, LOUISVILLE, KY 40223-1246
(407) 453-1036
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
096119
OH
Other
Enumeration date
03/13/2013
Last updated
03/13/2013
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