Healthcare Provider Details

I. General information

NPI: 1760418750
Provider Name (Legal Business Name): DANIEL ADAM GRAUBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 ROUTE 108
SOMERSWORTH NH
03878-1543
US

IV. Provider business mailing address

61 BEACON ST W STE 4
LACONIA NH
03246-3460
US

V. Phone/Fax

Practice location:
  • Phone: 603-692-3166
  • Fax: 603-692-3168
Mailing address:
  • Phone: 603-262-1737
  • Fax: 603-262-1737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LA0401X
TaxonomyAddiction Medicine (Anesthesiology) Physician
License Number12414
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number12414
License Number StateNH
# 3
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number12414
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: