Provider Demographics
NPI:1104826775
Name:DR. B ABRAHAM PC
Entity type:Organization
Organization Name:DR. B ABRAHAM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-978-1331
Mailing Address - Street 1:3020 HIGHWAY 124
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-4614
Mailing Address - Country:US
Mailing Address - Phone:770-978-1331
Mailing Address - Fax:770-978-8580
Practice Address - Street 1:3020 HIGHWAY 124
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-4614
Practice Address - Country:US
Practice Address - Phone:770-978-1331
Practice Address - Fax:770-978-8580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty