Provider Demographics
NPI:1497789556
Name:GRAHAM, ROBERT P JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:P
Last Name:GRAHAM
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 20TH AVE NORTH
Mailing Address - Street 2:STE 500
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203
Mailing Address - Country:US
Mailing Address - Phone:615-321-0032
Mailing Address - Fax:615-321-0417
Practice Address - Street 1:300 20TH AVE NORTH
Practice Address - Street 2:STE 500
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:615-321-0032
Practice Address - Fax:615-321-0417
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD13568207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2612554OtherCIGNA
IM67245OtherUNITED HEALTH CARE
TN34568OtherBLUE CROSS
2612554OtherCIGNA
C46914Medicare UPIN