=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649230632
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ADAM C ABRAM MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/24/2006
-----------------------------------------------------
Last Update Date | 10/10/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 145 PARK CENTRAL DR STE 100
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | SC
-----------------------------------------------------
Zip | 29203-6469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 803-736-3277
-----------------------------------------------------
Fax | 803-408-8698
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2025 TECHNOLOGY PKWY SUITE G-03
-----------------------------------------------------
City | MECHANICSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17050-9400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-728-9700
-----------------------------------------------------
Fax | 717-728-9800
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207YX0905X
-----------------------------------------------------
Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
-----------------------------------------------------
License Number | 17451
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------