Provider Demographics
NPI:1306423298
Name:CROAL-ABRAHAMS, LUQMAN (MD)
Entity type:Individual
Prefix:
First Name:LUQMAN
Middle Name:
Last Name:CROAL-ABRAHAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 DODD DR.
Mailing Address - Street 2:418 MCCAMPBELL HALL
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43210-1257
Mailing Address - Country:US
Mailing Address - Phone:614-293-4854
Mailing Address - Fax:614-257-2911
Practice Address - Street 1:1581 DODD DR.
Practice Address - Street 2:418 MCCAMPBELL HALL
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1257
Practice Address - Country:US
Practice Address - Phone:614-293-4854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-26
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12946207R00000X
390200000X
OH57.257479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program