Individual provider · Type 1 NPI

Mackenzie E. T. Graham, PA-C, MPH

Surgical Physician Assistant · Dayton, OH

NPI number 1619258068 Active

Practice location

One Wyoming Street
Dayton, OH 45409

Call (937) 208-2665 Map

Mailing address

309 Ives Ln
Kettering, OH 45429-3006

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X003317 (OH)

Surgical Physician Assistant: Definition to come...

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About NPI 1619258068

Mackenzie E. T. Graham, PA-C, MPH's National Provider Identifier is 1619258068, issued on Aug 30, 2011. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Dayton, OH. The record was last updated on Aug 30, 2011.