Individual
BRUCE M GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 W UNIVERSITY AVE, SUITE 300, MUNCIE, IN 47303-3400
(765) 281-2000
(765) 281-2062
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01039362A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060033596
MEDICARE B-RAILROAD
IN
05
—
100107270B
—
IN
01
—
P00413052
MEDICARE RROAD
IN
Enumeration date
03/14/2006
Last updated
01/07/2021
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