Healthcare Provider Details

I. General information

NPI: 1013133495
Provider Name (Legal Business Name): HARVEY A ABRAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 05/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57655 TAN OAK LANE
SUNRIVER OR
97707
US

IV. Provider business mailing address

3508 NW MCCREADY DR
BEND OR
97701-8627
US

V. Phone/Fax

Practice location:
  • Phone: 541-593-3165
  • Fax:
Mailing address:
  • Phone: 541-593-3165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMD08271
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: