Provider Demographics
NPI:1184895021
Name:DAVID S. GRAHAM, DC, PA
Entity type:Organization
Organization Name:DAVID S. GRAHAM, DC, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-253-5844
Mailing Address - Street 1:183 BARTLETT ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4306
Mailing Address - Country:US
Mailing Address - Phone:828-253-5844
Mailing Address - Fax:828-253-3573
Practice Address - Street 1:183 BARTLETT ST
Practice Address - Street 2:SUITE 120
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4306
Practice Address - Country:US
Practice Address - Phone:828-253-5844
Practice Address - Fax:828-253-3573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08457OtherBCBS NC
NC244434Medicare PIN
NC08457OtherBCBS NC