Graham, Mary V
Graham, Mary V is an sole proprietor health care provider with primary practice located at 10010 Kennerly Rd , Saint Louis MO 63128-2106. She recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as her primary health care specialty. Graham, Mary V can be contacted via phone (314) 525-1688.Contact Information
Primary practice address
10010 Kennerly Rd
Saint Louis MO 63128-2106
Phone: (314) 525-1688
Fax: (314) 525-1689
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Radiation Oncology | 2085R0001X | R3M43 | Missouri |
Profile Details
| NPI number | 1336121987 |
|---|---|
| LBN Legal business name | Graham, Mary V |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 18th, 2005 |
| Last updated | Apr 23rd, 2018 - about 8 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 | 1336121987 | NPPES |
| Missouri | MEDICAID | 208279513 |
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