Provider Demographics
NPI:1871021279
Name:GRAHAM, GEORGE PATERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PATERSON
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 1:4224 HOUMA BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2938
Mailing Address - Country:US
Mailing Address - Phone:504-503-4102
Mailing Address - Fax:504-456-6737
Practice Address - Street 1:4224 HOUMA BLVD STE 500
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2938
Practice Address - Country:US
Practice Address - Phone:504-503-4102
Practice Address - Fax:504-456-6737
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL41087207R00000X
LA322973207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine