| Nicole Graham | |
|
1401 W Innes St Salisbury NC 28144-2574 | |
| (704) 636-5626 | |
| (704) 636-5641 |
| Full Name | Nicole Graham |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1401 W Innes St, Salisbury, North Carolina |
| Authorized Official Name and Position | Chetan Amin (OFFICE MANAGER/OWNER) |
| Authorized Official Contact | 7046365626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Graham 1401 W Innes St Salisbury NC 28144-2574 Ph: (704) 636-5626 | Nicole Graham 1401 W Innes St Salisbury NC 28144-2574 Ph: (704) 636-5626 |
| NPI Number | 1225576242 |
|---|---|
| Provider Enumeration Date | 02/09/2017 |
| Last Update Date | 02/10/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225576242 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0010-07063 (North Carolina) | Primary |
| 314000000X | Skilled Nursing Facility | 0010-07063 (North Carolina) | Secondary |
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