| Marlon Anthony Graham, MD | |
|
512 Village Rd Ste 104, Shallotte, NC 28470-3409 | |
| (910) 721-4200 | |
| (910) 754-3811 |
| Full Name | Marlon Anthony Graham |
|---|---|
| Gender | Male |
| Speciality | Psychiatry |
| Experience | 43 Years |
| Location | 512 Village Rd Ste 104, Shallotte, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518921642 | NPI | - | NPPES |
| 179154 | Other | VA | ANTHEM |
| 179156 | Other | VA | ANTHEM |
| 178300 | Other | VA | ANTHEM |
| 01455137 | Other | VA | AMERIGROUP |
| 552451 | Other | VA | VALUE OPTIONS |
| 004945298 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 0101039537 (Virginia) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 2024-02500 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Novant Health Medical Group, Llc | 1153234893 | 2144 |
| Entity Name | Novant Health Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692 |
| Mailing Address | Practice Location Address |
|---|---|
| Marlon Anthony Graham, MD Po Box 60447, Charlotte, NC 28260-0447 Ph: () - | Marlon Anthony Graham, MD 512 Village Rd Ste 104, Shallotte, NC 28470-3409 Ph: (910) 721-4200 |
Borislav Margaritov Mravkov, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 204 Smith Ave, Shallotte, NC 28470 Phone: 910-721-4220 Fax: 910-721-4229 | |
Dr. David A. Joseph, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4647 Main St, Ste. 5, Shallotte, NC 28470 Phone: 910-755-6606 Fax: 910-755-6608 | |
Dr. Robert M. Licata, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 120 Coastal Horizons Dr, Shallotte, NC 28470 Phone: 910-754-4515 |