Provider Demographics
NPI:1497588834
Name:GRAHAM, SAVANNAH (PA)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 PEREGRINE PT
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-2194
Mailing Address - Country:US
Mailing Address - Phone:678-986-8134
Mailing Address - Fax:
Practice Address - Street 1:13081 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-5150
Practice Address - Country:US
Practice Address - Phone:770-521-6690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical