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General NPI Number Information
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NPI Number | 1427161736
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Entity Type | Individual
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Provider Name | DENNIS JOEL ABRAHAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 13005 38TH PLACE NORTH
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City | PLYMOUTH
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State | MN
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Zip | 55441
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Country | US
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Telephone | 612-381-6816
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Fax | 763-898-1040
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Provider Business Mailing Address
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Address Line | 13005 38TH PLACE NORTH
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City | PLYMOUTH
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State | MN
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Zip | 55441
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Country | US
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Telephone | 612-381-6816
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Fax | 763-488-4105
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23313
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License Number State | MN
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