| Graham Urological Center Llc | |
|
6300 Estate Peters Rst Ste 1 Christiansted VI 00820-5817 | |
| (340) 719-8761 | |
| Not Available |
| Full Name | Graham Urological Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6300 Estate Peters Rst Ste 1, Christiansted, Virgin Island |
| Authorized Official Name and Position | Emmanuel S Graham (DIRECTOR) |
| Authorized Official Contact | 3407198761 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Graham Urological Center Llc Po Box 6883 Christiansted VI 00823-6883 Ph: (340) 719-8761 | Graham Urological Center Llc 6300 Estate Peters Rst Ste 1 Christiansted VI 00820-5817 Ph: (340) 719-8761 |
| NPI Number | 1205149879 |
|---|---|
| Provider Enumeration Date | 07/23/2010 |
| Last Update Date | 12/08/2023 |
| Medicare PECOS PAC ID | 7618091513 |
|---|---|
| Medicare Enrollment ID | O20100830000586 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205149879 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 1455 (Virgin Island) | Primary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Secondary |
| Provider Name | Emmanuel S Graham |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275677965 PECOS PAC ID: 5395803159 Enrollment ID: I20081022000673 |
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