Graham, Fitzroy Henry
Graham, Fitzroy Henry is an sole proprietor health care provider with primary practice located at 105 Mirramont Lake Dr Ste 100 , Woodstock GA 30189-8214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Graham, Fitzroy Henry can be contacted via phone (770) 485-9670.Contact Information
Primary practice address
105 Mirramont Lake Dr Ste 100
Woodstock GA 30189-8214
Phone: (770) 485-9670
Fax: (678) 401-7658
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 048780 | Georgia |
Profile Details
| NPI number | 1538120092 |
|---|---|
| LBN Legal business name | Graham, Fitzroy Henry |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Feb 18th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1538120092 | NPPES |
| Georgia | MEDICAID | 000919663B |
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