Provider Demographics
NPI:1194807479
Name:MCGRAW, RICHARD B (OD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:B
Last Name:MCGRAW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 254
Mailing Address - Street 2:14 LITTLE VILLAGE LANE
Mailing Address - City:BELGRADE LAKES
Mailing Address - State:ME
Mailing Address - Zip Code:04918-0254
Mailing Address - Country:US
Mailing Address - Phone:207-495-2692
Mailing Address - Fax:
Practice Address - Street 1:DEPT. OF VETERANSAFFAIRS/TOGUS VA MEDICAL CENTER
Practice Address - Street 2:1 VA CENTER
Practice Address - City:TOGUS
Practice Address - State:ME
Practice Address - Zip Code:04330
Practice Address - Country:US
Practice Address - Phone:207-623-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT498152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist