Provider Demographics
NPI:1235450073
Name:GRAHAM, MATTHEW M (DO)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:M
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 S MERCY RD STE 211
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85297-0424
Mailing Address - Country:US
Mailing Address - Phone:480-728-9900
Mailing Address - Fax:480-961-2306
Practice Address - Street 1:3420 S MERCY RD STE 211
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-0424
Practice Address - Country:US
Practice Address - Phone:480-728-9900
Practice Address - Fax:480-728-9910
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ005822207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine