Healthcare Provider Details

I. General information

NPI: 1891754297
Provider Name (Legal Business Name): KURIAN CHIRAMEL ABRAHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 03/07/2023
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 LATROBE DR
CHARLOTTE NC
28211-4849
US

IV. Provider business mailing address

3101 LATROBE DR
CHARLOTTE NC
28211-4849
US

V. Phone/Fax

Practice location:
  • Phone: 704-817-8331
  • Fax: 704-817-8975
Mailing address:
  • Phone: 704-817-8331
  • Fax: 704-817-8975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number200100821
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number200100821
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number200100821
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number200100821
License Number StateNC
# 5
Primary TaxonomyY
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number200100821
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: