Individual
DR. FREDERICK S GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4280 WATERMELON RD STE 111, NORTHPORT, AL 35473-5250
(205) 333-8554
(205) 752-7696
Mailing address
4280 WATERMELON RD STE 111, NORTHPORT, AL 35473-5250
(205) 333-8554
(205) 752-7696
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
22790
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051510659
—
AL
05
—
107836
—
AL
05
—
1548212954
—
AL
01
—
51109440
BLUE CROSS BLUE SHIELD OF AL
AL
01
—
515-95961
BC BS OF AL
AL
01
—
515-97145
BC BS OF AL
AL
01
—
515-97150
BC BS OF AL
AL
01
—
51510659
BLUE CROSS BLUE SHIELD
AL
01
—
51517554
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/16/2006
Last updated
10/19/2023
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