Healthcare Provider Details

I. General information

NPI: 1376938514
Provider Name (Legal Business Name): ANN ALEXANDER ABRAHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2015
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W 8TH AVE STE 7060
SPOKANE WA
99204-2327
US

IV. Provider business mailing address

1201 W MOUNT ROYAL AVE UNIT 655
BALTIMORE MD
21217-5567
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-5437
  • Fax: 509-227-7070
Mailing address:
  • Phone: 516-713-6337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberD86088
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: