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NPI Code Detail

MEDICARE: DR. MARK GRAEBER DPM

MEDICARE: DR. MARK GRAEBER DPM
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
1213E00000XPodiatrist245SD
2213EP0504XPublic Medicine PodiatristPO3985FL
3213ES0103XFoot & Ankle Surgery PodiatristPO3985FL
4213E00000XPodiatrist1099MN
5213EP1101XPrimary Podiatric Medicine PodiatristPO3985FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770969875
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK GRAEBER DPM
Provider Business Mailing Address
First Line : PO BOX 5074
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57117-5074
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1210 W 18TH ST STE G01
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-4651
Country : US
Telephone Number : 605-328-2663
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2015
Last Update Date : 03/12/2026

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