Provider Demographics
NPI:1144429556
Name:GRAHAM, DIANA RACHEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:RACHEL
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:107 SUNNYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-1827
Mailing Address - Country:US
Mailing Address - Phone:919-250-1260
Mailing Address - Fax:919-747-0551
Practice Address - Street 1:107 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1827
Practice Address - Country:US
Practice Address - Phone:919-250-1260
Practice Address - Fax:919-747-0551
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-011752084P0800X
NY2184782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry