Healthcare Provider Details

I. General information

NPI: 1811559172
Provider Name (Legal Business Name): AFREEN ABRAHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2019
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 SOUTH DR STE 341
MOUNT PLEASANT MI
48858-3255
US

IV. Provider business mailing address

1201 SOUTH DR STE 341
MOUNT PLEASANT MI
48858-3255
US

V. Phone/Fax

Practice location:
  • Phone: 989-953-5313
  • Fax: 989-953-5316
Mailing address:
  • Phone: 989-953-5313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301513168
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: