Graham, Theodore K

Graham, Theodore K is an individual health care provider with primary practice located at 7815 E Jefferson Ave , Detroit MI 48214-3704. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Graham, Theodore K can be contacted via phone (313) 499-4868.

Contact Information

Primary practice address
7815 E Jefferson Ave Detroit MI 48214-3704
Phone: (313) 499-4868
Fax: (313) 499-4911
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 4301050455 Michigan

Profile Details

NPI number 1679562292
LBN Legal business name Graham, Theodore K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jul 13th, 2007 - about 19 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 1679562292 NPPES
Michigan MEDICAID 4502252

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