Provider Demographics
NPI:1265069249
Name:KALISH, ABIGAIL HARROVER (MD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:HARROVER
Last Name:KALISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:ELIZABETH
Other - Last Name:HARROVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:895 CANTON RD NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8934
Mailing Address - Country:US
Mailing Address - Phone:770-427-8111
Mailing Address - Fax:770-499-1643
Practice Address - Street 1:895 CANTON RD NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8934
Practice Address - Country:US
Practice Address - Phone:770-427-8111
Practice Address - Fax:770-499-1643
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA104493207WX0120X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases SpecialistGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program