Organization
K.W. GRAHAM, MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURT W GRAHAM MD (OWNER)
(415) 298-1678
Entity
Organization
Contact information
Practice address
300 PARK HILL DR, FREDERICKSBURG, VA 22401-3387
(804) 521-5315
(804) 477-1252
Mailing address
3900 WESTERRE PKWY STE 300, HENRICO, VA 23233-1339
(804) 521-5315
(804) 477-1252
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101259480
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306958848
—
VA
Enumeration date
04/17/2018
Last updated
04/17/2018
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