Individual
DR. GENE S GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1871 W WILLIAM ST, DELAWARE, OH 43015-2255
(740) 363-4373
(740) 363-9560
Mailing address
1871 W WILLIAM ST, DELAWARE, OH 43015-2255
(740) 363-4373
(740) 363-9560
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1839
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0344274-1221
—
OH
01
—
31-1062667
TAX ID
OH
Enumeration date
05/23/2005
Last updated
09/10/2015
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