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Individual

AUTUMN C GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
110 IRVING ST NW, WASHINGTON, DC 20010-2976
(202) 444-2116
(513) 557-3332
Mailing address
330 S WEST ST, APT 308, ALEXANDRIA, VA 22314-5915
(703) 254-7237

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35085236
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
75859902
BLUE SHIELD
MD
01
J8790001
BLUE SHIELD
DC
01
P00350406
RAILROAD MED
DC
Enumeration date
06/13/2005
Last updated
03/06/2008
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