Provider Demographics
NPI:1194715276
Name:ABRAMSON, JONATHAN D (M D)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:D
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3140 W CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2776
Mailing Address - Country:US
Mailing Address - Phone:989-893-3551
Mailing Address - Fax:989-893-1395
Practice Address - Street 1:3140 W CAMPUS DR
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706
Practice Address - Country:US
Practice Address - Phone:989-893-3551
Practice Address - Fax:989-893-1395
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060539207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900000628OtherTRAVELERS MEDICARE
MI1004083OtherMCLAREN HEALTH PLAN
MI3081343Medicaid
MI1100961982OtherBLUE CROSS BLUE SHIELD
MI1100961982OtherHEALTH PLUS OF MICHIGAN
MIM032999OtherTRICARE
MI1100961982OtherBLUE CARE NETWORK
MI1100961982OtherBLUE CROSS BLUE SHIELD
MI0096198Medicare ID - Type Unspecified