Individual
MS. MAI LINH T GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1722 STATE ROAD 44, NEW SMYRNA BEACH, FL 32168-8339
(386) 427-0390
(386) 427-0394
Mailing address
PO BOX 2616, NEW SMYRNA BEACH, FL 32170-2616
(386) 427-0390
(386) 427-0394
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9107182
FL
363AS0400X
Surgical Physician Assistant
PA757
NV
Other
Enumeration date
12/21/2006
Last updated
09/18/2015
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