Healthcare Provider Details

I. General information

NPI: 1861291205
Provider Name (Legal Business Name): ABEL CHERIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 N CAMPBELL AVE RM 5304D
TUCSON AZ
85724-0001
US

IV. Provider business mailing address

1501 N CAMPBELL AVE RM 5304D
TUCSON AZ
85724-0001
US

V. Phone/Fax

Practice location:
  • Phone: 623-428-4664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberR82580
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: