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Individual

DR. MARTHA T MCGRAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
336083241
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036121731
IL
01
206147
MEDICARE PTAN (GROUP)
IL
01
206147032
MEDICARE PTAN (INDIVIDUAL)
IL
05
336083241
IL
01
CA4748
MEDICARE RAILROAD PTAN (GROUP)
01
P00884745
MEDICARE RAILROAD PTAN (INDIVIDUAL)
Enumeration date
05/16/2006
Last updated
04/15/2013
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