Individual
ALEXANDER GRADY HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
895 TIGER BLVD, CLEMSON, SC 29631-1480
(864) 512-7257
(864) 654-7672
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-7257
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
24701
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/29/2020
Last updated
11/03/2022
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