Provider Demographics
NPI:1396834529
Name:GRAHAM-HOSKINS, PEARLY BERLETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:PEARLY
Middle Name:BERLETTE
Last Name:GRAHAM-HOSKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 517
Mailing Address - Street 2:300 A EAST MCKAY STREET
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:28337-0517
Mailing Address - Country:US
Mailing Address - Phone:910-862-5500
Mailing Address - Fax:910-862-2107
Practice Address - Street 1:300A EAST MCKAY STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NC
Practice Address - Zip Code:28337
Practice Address - Country:US
Practice Address - Phone:910-862-5500
Practice Address - Fax:910-862-2107
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22998207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC88440Medicare UPIN