Provider Demographics
NPI:1386628253
Name:OXNARD, GRAHAM M (MD)
Entity Type:Individual
Prefix:
First Name:GRAHAM
Middle Name:M
Last Name:OXNARD
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2831 SNELLING AVE N
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1712
Practice Address - Country:US
Practice Address - Phone:651-765-5900
Practice Address - Fax:651-765-5901
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2021-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN39512207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNG47271Medicare UPIN