Individual
GRAHAM K WETHERLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4424 E FLAMINGO AVE STE 300, NAMPA, ID 83687-9306
(208) 302-0200
(208) 302-0255
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 302-9342
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
M5449
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002755800
—
ID
Enumeration date
06/10/2006
Last updated
07/19/2022
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