MR. MICHAEL BRENT GRAHAM (NPI# 1336662964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336662964 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL BRENT GRAHAM |
| Practice Address |
2376 Cypress Cir Ste 300 Conway SC 29526-8995 |
| Practice Telephone | 8433477222 |
| Practice Fax Number | 8433473305 |
| Mailing Telephone | 8433477222 |
| Mailing Fax Number | 8433473305 |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | MPA.2870PA | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2870 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 921 Marshfield Cir Unit 306, Myrtle Beach, SC 295799486 | 8434243622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922459346 | Michael William Graham | Physical Therapist | 10 Playland Dr, Saint Albans, WV 25177-3440 | 2016-06-27 |
| 1164731477 | Michael Graham | Registered Nurse | 5728 Yearling St, Lakewood, CA 90713-1854 | 2010-10-04 |
| 1689801813 | Michael Patrick John Graham | Counselor | 3705 Marquette Ave Ne, Albuquerque, NM 87108-1031 | 2009-06-15 |
| 1861632507 | Michael Graham Sr. | Counselor | 796 Highland Avenue, Waterbury, CT 06708-4710 | 2009-02-20 |
| 1013125319 | Michael James Graham | Dentist | 406 3rd Ave Ne, Cullman, AL 35055-2928 | 2007-05-18 |
| 1598985657 | Michael Steven Graham | Family Medicine | 37 Haystack Rd, Hinesburg, VT 05461-6613 | 2007-04-30 |
| 1023237591 | Michael Bernard Graham | Internal Medicine | 2775 Sanders Rd, Suite C1, Northbrook, IL 60062-6110 | 2007-04-24 |
| 1902927502 | Michael Charles Graham | Hearing Instrument Specialist | 13112 Nacogdoches Rd Ste 2, San Antonio, TX 78217-1548 | 2007-04-02 |
| 1083776868 | Michael E Graham | Obstetrics & Gynecology | 4720 S I-10 Service Road, Suite 104, Metairie, LA 70001 | 2006-12-15 |
| 1205901477 | Michael Clyde Graham | Physician Assistant | 225 6th St, Potlatch, ID 83855-5002 | 2006-11-22 |
| Street Address |
2376 CYPRESS CIR STE 300 |
| City | CONWAY |
| State | SC |
| Zip Code | 29526-8995 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003986514 | William L. Mills | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-09 |
| 1669973517 | Orthosc LLC | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526 | 2018-02-26 |
| 1235302969 | Erkan Alci | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2008-04-02 |
| 1023212024 | John Christopher Gayton | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2007-06-13 |
| 1033278049 | Keith C Reinwald | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-12-06 |
| 1225103302 | Brian D. Forbus | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-22 |
| 1043385123 | Douglas T. Vick | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-22 |
| 1306910526 | Arthur J Preslar IIi | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-20 |
| 1962573352 | Jack S Haskin Jr. | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-10 |
| 1639240021 | Ross N Taylor | Orthopaedic Surgery | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457975237 | Terri L Champion | Massage Therapist | 172 Waccamaw Medical Park Court, Conway, SC 29526 | 2020-06-08 |
| 1689204398 | Alayna Defalco | Clinical Exercise Physiologist | 1320 501 Business, Unit E, Conway, SC 29526 | 2020-01-22 |
| 1124672662 | Proxsys Rx - Sc, LLC | Pharmacy | 300 Singelton Ridge Road, Conway, SC 29526 | 2019-08-01 |
| 1598227431 | Surgery Center of Conway Inc | Clinic/Center | 1405 Main Street, Conway, SC 29526 | 2019-04-01 |
| 1801374962 | Trevor James Hess | Specialist/Technologist | 905 One Landon Loop, Conway, SC 29526 | 2018-08-01 |
| 1851800817 | Katherine Ann Nimphius | Behavioral Analyst | 105 Timberline Dr, Conway, SC 29526 | 2017-09-21 |
| 1922544253 | William Houck | Specialist/Technologist | 925 One Landon Loop, Conway, SC 29526 | 2017-01-10 |
| 1952857278 | Courtney Jeanette Smith | Counselor | 164 Waccamaw Medical Park Dr., Conway, SC 29526 | 2016-08-28 |
| 1336502632 | Jebediah S. Christy, D.d.s - Conway, Pllc | Dentist | 2756 Church St, Conway, SC 29526 | 2016-04-04 |
| 1447615208 | Abl Enterprises, LLC | Optometrist | 113 Citadel Drive, Conway, SC 29526 | 2015-12-22 |
| Find all providers in zip 29526 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255622122 | Shan Fu | Physician Assistant | 2376 Cypress Cir, Suite 300, Conway, SC 29526-8964 | 2011-04-27 |
| 1831409135 | Tara Nicole Rogers | Physician Assistant | 550 Club Ln, Conway, AR 72034 | 2010-10-20 |
| 1336327741 | Christopher A Kearney | Physician Assistant | 2376 Cypress Cir, Ste 300, Conway, SC 29526-8995 | 2008-02-07 |
| 1033278049 | Keith C Reinwald | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-12-06 |
| 1043385123 | Douglas T. Vick | Physician Assistant | 2376 Cypress Cir Ste 300, Conway, SC 29526-8995 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140451 | Nichole Lemay | Physician Assistant | 9 Richland Medical Park Dr Ste 640, Columbia, SC 29203 | 2018-10-19 |
| 1588183909 | John Edward Carpenter | Physician Assistant | 50 E Hospital St Ste 6, Manning, SC 29102-3149 | 2017-09-18 |
| 1689116006 | Healing Hands Surgical Assisting | Physician Assistant | 456 Bates Crossing Rd, Travelers Rest, SC 29690-9277 | 2016-11-16 |
| 1003207101 | Kimberly Anne Caldwell | Physician Assistant | 306 Roosevelt Ave, Travelers Rest, SC 29690-1750 | 2015-02-10 |
| 1144653742 | Carrie Marie Thompson | Physician Assistant | 96 Jonathan Lucus Street, Csb He320e, Charleston, SC 29425 | 2013-08-19 |
| 1437400363 | William Travis Jeffcoat | Physician Assistant | 109 Health Way, Anderson, SC 29621-3333 | 2012-10-02 |
| 1609184316 | Kym L Kittle | Physician Assistant | 161 Ashley Ave, Charleston, SC 29425-8905 | 2010-09-15 |
| 1093960957 | Stephen Utenick | Physician Assistant | 105 Beason Farm Ln, Simpsonville, SC 29681-6509 | 2008-11-19 |
| 1689849457 | First Surgical Associates, LLC | Physician Assistant | 1004 Wells St, Bennettsville, SC 29512-2718 | 2008-04-23 |
| 1922270594 | Kati George Carter | Physician Assistant | 890 W Faris Rd Ste 550, Greenville, SC 29605-4286 | 2008-03-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. MICHAEL BRENT GRAHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.