=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821098344
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CYRIL ABRAMS M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2005
-----------------------------------------------------
Last Update Date | 02/16/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4275 WESTERN BLVD
-----------------------------------------------------
City | JACKSONVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28546-1100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-938-3099
-----------------------------------------------------
Fax | 910-938-3243
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 68
-----------------------------------------------------
City | POLLOCKSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28573-0068
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-938-3099
-----------------------------------------------------
Fax | 910-938-3243
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number | 2003-00434 NC
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------