Individual
DR. JOHN EDWARD GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 CHILDRENS PL, DIV PED EMERGENCY MED, SAINT LOUIS, MO 63110-1002
(314) 454-2341
(314) 454-4345
Mailing address
2401 GILLHAM RD, ATTN PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
04-49064
KS
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
2016027209
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200034313
—
MO
Enumeration date
03/22/2013
Last updated
11/25/2025
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