Individual
DR. STACY HAROLD GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8 RICHLAND MEDICAL PARK DR, SUITE 300, COLUMBIA, SC 29203-8005
(803) 256-6511
(803) 744-4731
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32537
SC
207RC0000X
Cardiovascular Disease Physician
32537
SC
207RI0011X
Interventional Cardiology Physician
Primary
32537
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
325375
—
SC
Enumeration date
10/04/2006
Last updated
10/01/2019
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