Provider Demographics
NPI:1831176312
Name:GRAICHEN, DANA F (MD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:F
Last Name:GRAICHEN
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 1:272 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-1815
Mailing Address - Country:US
Mailing Address - Phone:207-324-3380
Mailing Address - Fax:207-490-1716
Practice Address - Street 1:272 COTTAGE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-1815
Practice Address - Country:US
Practice Address - Phone:207-324-3380
Practice Address - Fax:207-636-5023
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH9375207W00000X
ME013866207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME129040000Medicaid
NH30009239Medicaid
MEMM559401Medicare PIN
MEE9110Medicare UPIN
ME129040000Medicaid