Individual
AUTUMN C GRAHAM
Active
Individual
AUTUMN C GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
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
Update your record
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