Graham, Mark G.
Graham, Mark G. is an individual health care provider with primary practice located at 2301 S Broad St Suite 205, Philadelphia PA 19148-3542. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Occupational Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Graham, Mark G. can be contacted via phone (215) 551-8660.Contact Information
Primary practice address
2301 S Broad St Suite 205
Philadelphia PA 19148-3542
Phone: (215) 551-8660
Fax: (215) 551-9247
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD-022223-E | Pennsylvania |
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | MD-022223-E | Pennsylvania |
Profile Details
| NPI number | 1245258482 |
|---|---|
| LBN Legal business name | Graham, Mark G. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Mar 24th, 2015 - about 11 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 | 1245258482 | NPPES |
| Pennsylvania | MEDICAID | 000810360 | |
| Pennsylvania | MEDICAID | 7569106 |
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