Healthcare Provider Details

I. General information

NPI: 1649667932
Provider Name (Legal Business Name): CHRISTOPHER ABRAHAM D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2015
Last Update Date: 09/08/2021
Certification Date: 09/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 EAST NORTH AVE. ALLEGHENY GENERAL HOSPITAL,
PITTSBURGH PA
15212
US

IV. Provider business mailing address

300 E MCBEE AVE STE 401
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3166
  • Fax:
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberOS020788
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number83131
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: