Healthcare Provider Details

I. General information

NPI: 1700808995
Provider Name (Legal Business Name): MICHAEL C ABRAHAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 11/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 SLAWSON ST
DOLGEVILLE NY
13329-1237
US

IV. Provider business mailing address

28 SLAWSON ST
DOLGEVILLE NY
13329-1237
US

V. Phone/Fax

Practice location:
  • Phone: 315-429-3996
  • Fax: 315-429-3997
Mailing address:
  • Phone: 315-429-3996
  • Fax: 315-429-3997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number154881
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: