Individual
THEODORE K GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7815 E JEFFERSON AVE, DETROIT, MI 48214-3704
(313) 499-4868
(313) 499-4911
Mailing address
43800 GARFIELD RD, CLINTON TWP, MI 48038-1136
(800) 848-0202
(586) 226-6949
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301050455
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4502252
—
MI
Enumeration date
10/17/2005
Last updated
07/13/2007
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