Healthcare Provider Details

I. General information

NPI: 1629309000
Provider Name (Legal Business Name): JOSEPH NICHOLAS ABRAHAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2010
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 AMBASSADOR CAFFERY PKWY STE A
LAFAYETTE LA
70506-6756
US

IV. Provider business mailing address

5959 S SHERWOOD FOREST BLVD
BATON ROUGE LA
70816-6038
US

V. Phone/Fax

Practice location:
  • Phone: 337-294-0900
  • Fax:
Mailing address:
  • Phone: 337-294-0900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number07253R
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number07523R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: