Provider Demographics
NPI:1164684239
Name:GRAVES, REID V (MD)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:V
Last Name:GRAVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 300
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33731-0300
Mailing Address - Country:US
Mailing Address - Phone:727-822-9208
Mailing Address - Fax:727-822-9211
Practice Address - Street 1:830 CENTRAL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3622
Practice Address - Country:US
Practice Address - Phone:727-822-9208
Practice Address - Fax:727-822-9211
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMT193553208800000X
FLME118810208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology