Provider Demographics
NPI:1568445369
Name:GRAHAM, SCOT C (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOT
Middle Name:C
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 450
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2255
Mailing Address - Country:US
Mailing Address - Phone:303-738-1100
Mailing Address - Fax:303-738-1310
Practice Address - Street 1:7780 S BROADWAY STE 280
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2633
Practice Address - Country:US
Practice Address - Phone:303-738-1100
Practice Address - Fax:303-738-1310
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO34173207VG0400X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01341734Medicaid
G46344Medicare UPIN
COD9358Medicare PIN
CO01341734Medicaid