Provider Demographics
NPI:1851910061
Name:GRAHAM, BRETT ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:ROBERT
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 1:3618 GROSVENOR RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2631
Mailing Address - Country:US
Mailing Address - Phone:407-412-3102
Mailing Address - Fax:
Practice Address - Street 1:1301 MEDICAL CENTER DRIVE
Practice Address - Street 2:3930 THE VANDERBILT CLINIC
Practice Address - City:NASVHILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-5400
Practice Address - Country:US
Practice Address - Phone:615-936-0060
Practice Address - Fax:615-936-0223
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program