Provider Demographics
NPI:1689674277
Name:GRABENSTETTER, NEIL FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:FRANCES
Last Name:GRABENSTETTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6605 CENTER RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY CITY
Mailing Address - State:OH
Mailing Address - Zip Code:44280-9748
Mailing Address - Country:US
Mailing Address - Phone:330-483-3135
Mailing Address - Fax:330-483-3878
Practice Address - Street 1:6605 CENTER RD
Practice Address - Street 2:
Practice Address - City:VALLEY CITY
Practice Address - State:OH
Practice Address - Zip Code:44280-9748
Practice Address - Country:US
Practice Address - Phone:330-483-3135
Practice Address - Fax:330-483-3878
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045377207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0464297Medicaid
OHA79949Medicare UPIN
OHGR0492421Medicare ID - Type Unspecified