Healthcare Provider Details

I. General information

NPI: 1013673060
Provider Name (Legal Business Name): MICHAEL K ABRAHAMS JR. LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2021
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 W OSTEND ST STE 150
BALTIMORE MD
21230-3799
US

IV. Provider business mailing address

175 W OSTEND ST STE 150
BALTIMORE MD
21230-3799
US

V. Phone/Fax

Practice location:
  • Phone: 484-965-9966
  • Fax:
Mailing address:
  • Phone: 484-965-9966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA2647
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: