Provider Demographics
NPI:1427017664
Name:GRABER, SHARI F (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:F
Last Name:GRABER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2304 SANDOLLAR CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1235
Mailing Address - Country:US
Mailing Address - Phone:757-496-8965
Mailing Address - Fax:
Practice Address - Street 1:2304 SANDOLLAR CT
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-1235
Practice Address - Country:US
Practice Address - Phone:757-496-8965
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601001496152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0618000317OtherOPTOMETRIST TPA
VAT21425Medicare UPIN