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Individual

GRAHAM LUKE MACHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 805-0805
(414) 955-0122
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-0805
(414) 955-0122

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
68533
WI
208800000X
Urology Physician
BP10047349
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447695317
WI
Enumeration date
05/06/2013
Last updated
06/22/2018
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