Charles Dudley Graham, MD

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

11628 Issued in SC

Practice address

2910 Tricom St
North Charleston, SC 29406-9350

Phone

(843) 572-9211

Fax

(843) 572-0457

NPI assigned

May 24, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257379200000",
    "number": "1043213960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069350",
            "telephone_number": "843-572-9211",
            "fax_number": "843-572-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 TRICOM ST",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294069350",
            "telephone_number": "843-572-9211",
            "fax_number": "843-572-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHARLES",
        "middle_name": "DUDLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2009-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "SC",
            "license": "11628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116289",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Graceful Home Care Agency, LLC
• Graceful Living Behavioral Support
• Catherine Grady
• Gemma Grady, RN
• Annalise Graham
• Clarissa Graham
• Tyehimba Salim Grant Amar Bey, CERTIFIED HAIR LOSS
• Alyssa Howard Grant, PA-C
• Kristi Michelle Grant, COTA/L
• Sheila Grant

• Hematology & Oncology Physician in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Hematology & Oncology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.