DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. MICHAEL CLYDE GRAHAM, P.A.

Active

Physician Assistant · POTLATCH, ID

Registration Details

NPI Number
1205901477
Provider Type
Individual
Gender
Male
NPI Issued
Nov 22, 2006 (19.446215181883 yrs)
Last Updated
Jun 20, 2012
License
PA594 (ID)

Practice Information

Address
225 6TH ST
POTLATCH, ID, 838555002
Browse ID providers · Browse ZIP 83855
Phone
2088832220
Primary Specialty
Physician Assistant
363A00000X

Other Physician Assistant Providers in POTLATCH, ID

Name Credential NPI
CHARLOTTE S AINGE PAC 1689661050
SKYLER S WORTHINGTON PA-C 1992091722
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.