Charles Raymond Graham Jr., M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D24781 Issued in MD

Practice address

1001 Pine Heights Ave
Suite 300
Baltimore, MD 21229

Phone

(410) 646-5470

Fax

(410) 646-5471

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

Yes

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

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282003200000",
    "number": "1720077290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PINE HEIGHTS AVE",
            "address_2": "STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21229",
            "telephone_number": "410-646-5470",
            "fax_number": "410-646-5471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 PINE HEIGHTS AVE",
            "address_2": "SUITE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21229",
            "telephone_number": "410-646-5470",
            "fax_number": "410-646-5471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2010-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D24781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "336621900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Katherine Graf, M.D.
• Christian Gragasin
• Stephen D Gragg, PHD
• James N Graham-Hayes, COTA
• Charles Raymond Graham III, M.AC., L.AC., DIPL.A
• Christina Bradley Graham, NP
• Daniella J Graham
• Erik Wade Graham, LMT
• Ernest Marshall Graham, M.D.
• Giesha N Graham

• Internal Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.