Healthcare Provider Details

I. General information

NPI: 1255395844
Provider Name (Legal Business Name): MATTHEW EVAN ABRAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 E WILLETTA ST ROOM 3503
PHOENIX AZ
85006-2727
US

IV. Provider business mailing address

9612 N 117TH WAY
SCOTTSDALE AZ
85259-6362
US

V. Phone/Fax

Practice location:
  • Phone: 602-546-0676
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number32312
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: