Provider Demographics
NPI:1548904477
Name:GRAHAM, PERRY ALTON
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:ALTON
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 IRVING ST NW APT 201
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2435
Mailing Address - Country:US
Mailing Address - Phone:240-741-9360
Mailing Address - Fax:
Practice Address - Street 1:1200 IRVING ST NW APT 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2435
Practice Address - Country:US
Practice Address - Phone:240-741-9360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion