Individual
BENJAMIN MATTHEW GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5715 MEMORIAL AVE N, OAK PARK HEIGHTS, MN 55082-1093
(651) 439-8807
(651) 439-0232
Mailing address
4200 DAHLBERG DR STE 300, GOLDEN VALLEY, MN 55422-4841
(952) 512-5600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13701
MN
363A00000X
Physician Assistant
5590-23
WI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/31/2021
Last updated
12/13/2022
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