Most Relevant Information
Provider Data
| NPI Number: | 1003562554 |
| Provider Name: | SUSANNAH GRAHAM PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/23/2022 |
| Last Updated: | 03/21/2022 |
Provider Practice Location
805 PAMPLICO HWY
FLORENCE
SC
295056047
Practice Location Phone/Fax
| Phone: | 8437921414 |
| Fax: |
Provider Mailing Location
PO BOX 935722
ATLANTA
GA
311935722
Provider Mailing Phone/Fax
| Phone: | 8437926200 |
| Fax: |