Healthcare Provider Details

I. General information

NPI: 1841124724
Provider Name (Legal Business Name): ABRAHAM HOGAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

581 S RANGELINE RD STE B2
CARMEL IN
46032-2149
US

IV. Provider business mailing address

482 WHISPER LN
GREENWOOD IN
46142-1153
US

V. Phone/Fax

Practice location:
  • Phone: 317-669-9774
  • Fax:
Mailing address:
  • Phone: 317-946-1464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: