Graham, Michelle L
Graham, Michelle L is an individual health care provider with primary practice located at 2055 Kimball Ave Suite 101, Waterloo IA 50702-5047. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Graham, Michelle L can be contacted via phone (319) 272-2112.Contact Information
Primary practice address
2055 Kimball Ave Suite 101
Waterloo IA 50702-5047
Phone: (319) 272-2112
Fax: (319) 272-2107
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 34189 | Iowa |
Profile Details
| NPI number | 1295722106 |
|---|---|
| LBN Legal business name | Graham, Michelle L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2005 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1295722106 | NPPES |
| Iowa | MEDICAID | I245332 |
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