Individual
DR. JOSEPH A GRAVERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 W LANCASTER AVE, SUITE 200, PAOLI, PA 19301-1749
(610) 525-2515
Mailing address
209 W LANCASTER AVE, SUITE 200, PAOLI, PA 19301-1749
(610) 525-2515
(610) 527-6586
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
256182
NY
208800000X
Urology Physician
Primary
A117518
CA
208800000X
Urology Physician
MD445817
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1090905
—
LA
Enumeration date
07/30/2007
Last updated
08/14/2013
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