Healthcare Provider Details

I. General information

NPI: 1568560514
Provider Name (Legal Business Name): JEFFREY ABRAMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 CLARINBRIDGE WAY
ALPHARETTA GA
30022-6418
US

IV. Provider business mailing address

510 CLARINBRIDGE WAY
ALPHARETTA GA
30022-6418
US

V. Phone/Fax

Practice location:
  • Phone: 770-401-7292
  • Fax:
Mailing address:
  • Phone: 770-401-7292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number030707
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number030707
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: