Provider Demographics
NPI:1124327820
Name:GRAHAM, ZACHERY T (PHD, PHARMACY)
Entity type:Individual
Prefix:MR
First Name:ZACHERY
Middle Name:T
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:PHD, PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5181 OVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1730
Mailing Address - Country:US
Mailing Address - Phone:989-284-4384
Mailing Address - Fax:
Practice Address - Street 1:4801 MCLEOD DR E
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-2840
Practice Address - Country:US
Practice Address - Phone:989-790-2709
Practice Address - Fax:989-790-7989
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302036162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist