Individual
JOHN MCKAY GRAHAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
594 LONE TREE DR BLDG 6, MT PLEASANT, SC 29464-8170
(843) 958-2500
(843) 958-2680
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
12856
SC
207X00000X
Orthopaedic Surgery Physician
12856
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
12856
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128560
—
SC
01
—
P00648646
RAILROAD MEDICARE ID
SC
01
—
P00754387
RAILROAD MC ID-RSFPN
SC
Enumeration date
07/12/2006
Last updated
01/21/2025
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