Graber, Mary Evelyn
Graber, Mary Evelyn is an individual health care provider with primary practice located at 611 E Douglas Suite 309, Mishawaka IN 46545-1467. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Graber, Mary Evelyn can be contacted via phone (574) 252-2640.Contact Information
Primary practice address
611 E Douglas Suite 309
Mishawaka IN 46545-1467
Phone: (574) 252-2640
Fax: (574) 252-2650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01031977 | Indiana |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | 01031977 | Indiana |
Profile Details
| NPI number | 1427097682 |
|---|---|
| LBN Legal business name | Graber, Mary Evelyn |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Sep 14th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427097682 | NPPES |
| Indiana | Other | 000000542787 | BCBS |
| Indiana | Other | 000000269216 | BCBS |
| Indiana | MEDICAID | 200069280A | BCBS |
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