Individual
DR. OSWALD CALVIN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
814 WEST 21ST ST, CLORIS, NM 88101
(505) 769-2674
(505) 762-9304
Mailing address
814 WEST 21ST ST, CLORIS, NM 88101
(505) 769-2674
(505) 762-9304
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8154
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0003798
—
NM
01
—
NM001109
BCBS
—
Enumeration date
10/17/2006
Last updated
07/08/2007
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