Individual
KEVIN T GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1264 WEAVER DR, GRANVILLE, OH 43023-1257
(220) 564-1950
(220) 564-1951
Mailing address
1264 WEAVER DR, GRANVILLE, OH 43023-1257
(220) 564-1950
(220) 564-1951
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35.096582
OH
207Q00000X
Family Medicine Physician
Primary
35.096582
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3114105
—
OH
Enumeration date
07/10/2007
Last updated
03/18/2021
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