Provider Demographics
NPI:1801895552
Name:GRABER, ALVIN R (MD)
Entity type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:R
Last Name:GRABER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:357 N NAPPANEE ST
Mailing Address - Street 2:
Mailing Address - City:NAPPANEE
Mailing Address - State:IN
Mailing Address - Zip Code:46550-1625
Mailing Address - Country:US
Mailing Address - Phone:574-773-3141
Mailing Address - Fax:574-773-3143
Practice Address - Street 1:357 N NAPPANEE ST
Practice Address - Street 2:
Practice Address - City:NAPPANEE
Practice Address - State:IN
Practice Address - Zip Code:46550-1625
Practice Address - Country:US
Practice Address - Phone:574-773-3141
Practice Address - Fax:574-773-3143
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01020112A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B28612Medicare UPIN
184640AMedicare ID - Type Unspecified