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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
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01039362A
IN
207RC0000X
Cardiovascular Disease Physician
01039362A
IN
207RI0011X
Interventional Cardiology 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
06/15/2026
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