Provider Demographics
NPI:1609801042
Name:GRAUX, PATRICK JACQUE (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:JACQUE
Last Name:GRAUX
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4365 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-2603
Mailing Address - Country:US
Mailing Address - Phone:301-262-2346
Mailing Address - Fax:301-262-4999
Practice Address - Street 1:4365 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2603
Practice Address - Country:US
Practice Address - Phone:301-262-2346
Practice Address - Fax:301-262-4999
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1805111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD745184900Medicaid
MD745184900Medicaid
MDU64929Medicare UPIN