Theodore K Graham MD PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301050455 Issued in MI

Legal business name

THEODORE K GRAHAM MD PC

Practice address

12900 W 9 Mile Rd
Oak Park, MI 48237-2990

Phone

(248) 547-9292

Fax

(248) 547-2985

NPI assigned

Oct 6, 2010

Last updated

Oct 6, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Theodore K Graham, MD

Title

President

Phone

(248) 547-9292

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1286323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286323200000",
    "number": "1316256472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3337",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480373337",
            "telephone_number": "248-547-9292",
            "fax_number": "248-547-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 W 9 MILE RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372990",
            "telephone_number": "248-547-9292",
            "fax_number": "248-547-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE K GRAHAM MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-06",
        "last_updated": "2010-10-06",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-547-9292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301050455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2010; 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.