Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD054229L | PA |
NPI | 1205897964 |
---|---|
Provider Name | Dr. David James Abraham |
First Address | Wyomissing, PA 19610-3203 |
Second Address | Wyomissing, PA 19610-3203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 15/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
BA4306343 | DEA # (01) | PA |
DA6715 | RAILROAD MEDICARE (01) | PA |
G65924 | (02) | PA |
MD05842296 | MED LIC # (01) | PA |