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General NPI Number Information
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NPI Number | 1356668768
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Entity Type | Individual
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Provider Name | ALLISTAIR ABRAHAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2010
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 202-476-6690
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37215
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City | BALTIMORE
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State | MD
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Zip | 21297-3215
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Country | US
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Telephone |
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Fax |
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 43556
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License Number State | TN
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