Provider Demographics
NPI:1346489408
Name:GRAZIANO, JOEL ROBERT I (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ROBERT
Last Name:GRAZIANO
Suffix:I
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOEL
Other - Middle Name:ROBERT
Other - Last Name:GRAZIANO
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:42 WATERWAY ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:ISLE OF PALMS
Mailing Address - State:SC
Mailing Address - Zip Code:29451-2728
Mailing Address - Country:US
Mailing Address - Phone:843-886-4106
Mailing Address - Fax:843-886-4106
Practice Address - Street 1:42 WATERWAY ISLAND DR
Practice Address - Street 2:
Practice Address - City:ISLE OF PALMS
Practice Address - State:SC
Practice Address - Zip Code:29451-2728
Practice Address - Country:US
Practice Address - Phone:843-886-4106
Practice Address - Fax:843-886-4106
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5745207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery