Provider Demographics
NPI:1669408548
Name:GRABER, DONALD D (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:D
Last Name:GRABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8 E COTTONWOOD ST BLDG A
Mailing Address - Street 2:VERDE VALLEY GUIDANCE CLINIC, INC.
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-6237
Mailing Address - Country:US
Mailing Address - Phone:928-634-2236
Mailing Address - Fax:928-634-8960
Practice Address - Street 1:8 E COTTONWOOD ST BLDG C
Practice Address - Street 2:VERDE VALLEY GUIDANCE CLINIC, INC.
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-6237
Practice Address - Country:US
Practice Address - Phone:928-634-2236
Practice Address - Fax:928-634-8960
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01024485A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000375988OtherANTHEM
IN100112580Medicaid
INP00310132OtherANTHEM PIN
IN100112580Medicaid
INP00310132OtherANTHEM PIN