Individual
GEORGE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-5515
Mailing address
701 GROVE RD, GREENVILLE, SC 29605-4210
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL87755
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2022
Last updated
03/21/2023
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