Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 9700005 | NC |
NPI | 1003848540 |
---|---|
Provider Name | Victor E Abraham |
First Address | Wilmington, NC 28401-7367 |
Second Address | Wilmington, NC 28401-7353 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2006 |
Last Update Date | 27/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G67489 | (02) |