Graham Dermatology PA
Organization Active NPI Specialist · Mebane, NC
NPI 1619208345 · NPPES record last updated Jul 30, 2026
Key facts
- NPI
- 1619208345
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 2006-01011 (NC)
- Legal business name
- GRAHAM DERMATOLOGY PA
- Practice address
- 202 Fieldale Rd
Mebane, NC 27302-9177 - Phone
- (919) 304-5900
- Fax
- (919) 304-5901
- NPI assigned
- Jan 20, 2010
- Organization subpart
- No
Authorized official
- Name
- Spencer Ellis
- Title
- Director of Operations
- Phone
- (919) 304-5900
Practitioners 1
-
Ana Benitez-Graham, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100331001167 | NC | Part B Supplier - Clinic/Group Practice | 4688700313 |
Receives reassigned benefits from 1 practitioner Practice locations: Mebane, NC |
National Provider Directory
Locations
202 Fieldale Rd
Mebane, NC 27302
Phone (919) 304-5900
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 2006-01011 | NC | Yes |
Addresses
Primary practice location
202 Fieldale Rd
Mebane, NC 27302-9177
Mailing address
202 Fieldale Rd
Mebane, NC 27302-9177
Phone (919) 304-5900
Other providers in Mebane, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.