Basic Information
| Provider Information | |||||||||
| NPI: | 1316913072 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAHAM | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | MCLAURIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2051 CHARLIE HALL BLVD | ||||||||
| Address2: | |||||||||
| City: | CHAS | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294145879 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435732535 | ||||||||
| FaxNumber: | 8435732534 | ||||||||
| Practice Location | |||||||||
| Address1: | 2051 CHARLIE HALL BLVD | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294145834 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435732535 | ||||||||
| FaxNumber: | 8435732534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2006 | ||||||||
| LastUpdateDate: | 08/19/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 18368 | SC | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.