Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | DS 035371-L | PA |
N | 1223G0001X | General Practice | DS035371L | PA |
N | 213EG0000X | General Practice | DS035371L | PA |
NPI | 1942310768 |
---|---|
Provider Name | Dr. Joseph Gregory Graver |
First Address | Etters, PA 17319-9536 |
Second Address | Etters, PA 17319-9536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 11/04/2016 |