Healthcare Provider Details

I. General information

NPI: 1831176312
Provider Name (Legal Business Name): DANA F GRAICHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 COTTAGE ST
SANFORD ME
04073-1815
US

IV. Provider business mailing address

272 COTTAGE ST
SANFORD ME
04073-1815
US

V. Phone/Fax

Practice location:
  • Phone: 207-324-3380
  • Fax: 207-636-5023
Mailing address:
  • Phone: 207-324-3380
  • Fax: 207-490-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number9375
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number013866
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: