Individual
DR. JOHN MAITLAND GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
320 LINCOLN WAY E, OSCEOLA, IN 46561-2767
(574) 674-6700
(574) 674-7171
Mailing address
320 LINCOLN WAY E, OSCEOLA, IN 46561-2767
(574) 674-6700
(574) 674-7171
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
02001454A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093107
ANTHEM
IN
05
—
200187380B
—
IN
01
—
RR MEDICARE
200034182
IN
Enumeration date
06/28/2005
Last updated
10/20/2008
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