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NPI Code Detail

MEDICARE: EMMA GRABER

MEDICARE: EMMA GRABER
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
1363A00000XPhysician Assistant10003310AIN
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1588239701
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA GRABER
Provider Business Mailing Address
First Line : 4600 SUNSET AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-3443
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 SUNSET AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46208-3443
Country : US
Telephone Number : 317-940-6026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2021
Last Update Date : 07/26/2021

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Directions to “ EMMA GRABER ” Practice Location

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