Organization
OBGYN BILLING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E GRAHAM MD (OWNER)
(504) 457-0299
Entity
Organization
Contact information
Practice address
4720 S I 10 SERVICE RD W STE 104, METAIRIE, LA 70001-7403
(504) 457-0299
Mailing address
4720 S I 10 SERVICE RD W STE 104, METAIRIE, LA 70001-7403
(504) 457-0299
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L018221
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1445002
—
LA
Enumeration date
03/27/2008
Last updated
03/27/2008
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