MR. Michael Clyde Graham, P.A.

NPI #1205901477 in Potlatch, Idaho

Provider Information

NPI Number: 1205901477
Entity Type: Individual
Name: MR. Michael Clyde Graham, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Nov 22, 2006
Last Updated: Jun 20, 2012

Practice Location

Address: 225 6TH ST
City: Potlatch
State: Idaho
ZIP Code: 83855-5002
Phone: (208) 883-2220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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