Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 4945029-1206 | UT |
NPI | 1003855768 |
---|---|
Provider Name | Jeffery H Abram |
First Address | American Fork, UT 84003-1253 |
Second Address | Pleasant Grove, UT 84062-4104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2006 |
Last Update Date | 08/07/2007 |