MEDICARE: DR. FREDERICK M GRAFF D.C.

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	111NX0800X	Orthopedic Chiropractor	1276	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SO9244221	OTHER	OH	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	31-1318184-00	OTHER	OH	WORKERS COMPENSATION
3	44-000139	OTHER	OH	UNITED HEALTHCARE OF OHIO
4	119611	OTHER	OH	ANTHEM BC/BS

General Provider Information

NPI Number	:	1710070834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK M GRAFF D.C.

Provider Business Mailing Address
First Line	:	3009 COLUMBUS ST
Second Line	:	P. O. BOX 577, SUITE 101
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2763
Country	:	US
Telephone Number	:	614-871-8400
Fax Number	:	614-871-8897

Provider Business Practice Location Address
First Line	:	3009 COLUMBUS ST STE 101
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2763
Country	:	US
Telephone Number	:	614-871-8400
Fax Number	:	614-871-8897

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	05/17/2010

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