Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 22206 | NC |
NPI | 1033194691 |
---|---|
Provider Name | Jon Stuart Abramson |
First Address | Winston-Salem, NC 27157 |
Second Address | Winston-Salem, NC 27157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 16/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10139 | BLUE CROSS (01) | |
214175000 | (05) | WV |
46689 | MEDCOST (01) | |
5298147 | AETNA (01) | |
6760198 | (05) | VA |
8910139 | (05) | NC |
C82550 | (02) | |
PARTNERS | 2899 (01) | |
Q22206 | (05) | SC |