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General NPI Number Information
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NPI Number | 1245239623
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Entity Type | Individual
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Provider Name | TIMOTHY GARTH ABRAHAMSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 2424 128TH ST NW 128TH STREET
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City | URBANDALE
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State | IA
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Zip | 50323-1816
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Country | US
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Telephone | 515-243-8676
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Fax | 515-243-0487
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Provider Business Mailing Address
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Address Line | 2424 128TH ST NW 128TH STREET
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City | URBANDALE
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State | IA
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Zip | 50323-1816
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Country | US
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Telephone | 515-243-8676
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Fax | 515-243-0487
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number | 33182
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 33182
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License Number State | IA
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