Provider Demographics
NPI:1710991575
Name:GRABER, RODNEY C (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:C
Last Name:GRABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-932-4629
Mailing Address - Fax:540-932-4616
Practice Address - Street 1:78 MEDICAL CENTER DR
Practice Address - Street 2:HEART & VASCULAR CENTER, 2ND FLOOR
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2332
Practice Address - Country:US
Practice Address - Phone:540-245-7080
Practice Address - Fax:540-245-7081
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35070871207RC0000X
VA0101250484207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2123311Medicaid
VAGC1100Medicare PIN
OH2123311Medicaid
OHGR0871719Medicare PIN