Provider Demographics
NPI:1467542977
Name:GRAHAM, CAMILLE CECILE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAMILLE
Middle Name:CECILE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 UNIVERSITY DR STE D
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6563
Mailing Address - Country:US
Mailing Address - Phone:513-948-8444
Mailing Address - Fax:
Practice Address - Street 1:8250 KENWOOD CROSSING WAY
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-3668
Practice Address - Country:US
Practice Address - Phone:513-948-8444
Practice Address - Fax:513-948-0756
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044973208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0438593Medicaid