Doctor Name: | THEODORE K GRAHAM |
NPI Number: | 1679562292 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301050455 |
Business Practice Address: | 7815 E Jefferson Ave Detroit, MI - 482143704 |
Business Phone Number: | 3134994868 |
Business Fax Number: | 3134994911 |
Mailing Address: | 43800 Garfield Rd, CLINTON TWP |
State: | MI |
Postal Code: | 480381136 |
Phone Number: | 8008480202 |
Fax Number: | 5862266949 |
NPI Enumeration Date: | 10/17/2005 |
NPI Last Update Date: | 07/13/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 4301050455 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |