Provider Demographics
NPI:1699440313
Name:GRAHAM, ANISA MARIE (PHLEBOTOMIST/MA)
Entity type:Individual
Prefix:MRS
First Name:ANISA
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PHLEBOTOMIST/MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:5091 BREEZEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:INDIAN HEAD
Mailing Address - State:MD
Mailing Address - Zip Code:20640-3731
Mailing Address - Country:US
Mailing Address - Phone:301-710-7674
Mailing Address - Fax:240-903-2126
Practice Address - Street 1:5091 BREEZEWOOD CT
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-3731
Practice Address - Country:US
Practice Address - Phone:301-710-7674
Practice Address - Fax:240-903-2126
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246R00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Pathology