=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730264110
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARC E ABRAMSON MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2006
-----------------------------------------------------
Last Update Date | 08/28/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4007 ESTATE DIAMOND RUBY
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00820-4435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 340-778-6311
-----------------------------------------------------
Fax | 888-686-4557
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7098
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00823-7098
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 340-778-3611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 38824
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 2208
-----------------------------------------------------
License Number State | VI
-----------------------------------------------------