Provider Demographics
NPI:1043527286
Name:DONALD, GRAHAM W (MD)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:W
Last Name:DONALD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:190 E BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83712-6241
Mailing Address - Country:US
Mailing Address - Phone:208-381-8866
Mailing Address - Fax:
Practice Address - Street 1:333 N 1ST ST STE 280
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-6132
Practice Address - Country:US
Practice Address - Phone:208-345-6545
Practice Address - Fax:208-345-1213
Is Sole Proprietor?:No
Enumeration Date:2010-09-09
Last Update Date:2023-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IDM-140012086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery