Graham, Gary Robert

Graham, Gary Robert is an individual health care provider with primary practice located at 2776 Enterprise Rd # 100 , Orange City FL 32763-8316. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Graham, Gary Robert can be contacted via phone (386) 774-1223.

Contact Information

Primary practice address
2776 Enterprise Rd # 100 Orange City FL 32763-8316
Phone: (386) 774-1223
Fax: (386) 774-4658
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X ME68452 Florida

Profile Details

NPI number 1538160692
LBN Legal business name Graham, Gary Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Dec 13th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538160692 NPPES
Florida MEDICAID 379101700

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