Individual
DR. WAYNE R GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1473 S HIGHWAY 40, SUITE E, HEBER CITY, UT 84032-3522
(435) 657-4400
(435) 657-4460
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(435) 657-4400
(435) 657-4460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
59602551204
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59602551204
STATE LICENSE NO
UT
Enumeration date
07/31/2006
Last updated
02/27/2014
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