Provider Demographics
NPI:1750261707
Name:GRAHAM MOUW, MD, PROFESSIONAL ASSOCIATION
Entity type:Organization
Organization Name:GRAHAM MOUW, MD, PROFESSIONAL ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-770-2489
Mailing Address - Street 1:90 ALTON RD APT 804
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33139-6879
Mailing Address - Country:US
Mailing Address - Phone:310-770-2489
Mailing Address - Fax:
Practice Address - Street 1:90 ALTON RD APT 804
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33139-6879
Practice Address - Country:US
Practice Address - Phone:310-770-2489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty