MEDICARE: DR. SHARI F GRABER OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0601001496	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0618000317	OTHER	VA	OPTOMETRIST TPA

General Provider Information

NPI Number	:	1427017664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARI F GRABER OD

Provider Business Mailing Address
First Line	:	2304 SANDOLLAR CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1235
Country	:	US
Telephone Number	:	757-496-8965
Fax Number	:

Provider Business Practice Location Address
First Line	:	2304 SANDOLLAR CT
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-1235
Country	:	US
Telephone Number	:	757-496-8965
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	07/09/2007

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