Provider Demographics
NPI:1881777332
Name:GRAHAM, PAUL ABRAM (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:ABRAM
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2835 20TH STREET
Mailing Address - Street 2:BUILDING C
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-299-3003
Mailing Address - Fax:772-299-3005
Practice Address - Street 1:2835 20TH STREET
Practice Address - Street 2:BUILDING C
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-299-3003
Practice Address - Fax:772-299-3005
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55283207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC48079Medicare UPIN
FL08612WMedicare ID - Type Unspecified