MEDICARE: THOMAS RAYMOND ABRAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	12516	AZ
2	2085U0001X	Diagnostic Ultrasound Physician	12516	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	300024018	OTHER	AZ	MEDICARE RAILROAD
5	CS7943	OTHER	AZ	GROUP MEDICARE RAILROAD ID & PTAN
7	ZWCBBM	OTHER	AZ	GROUP MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1023089158	OTHER	AZ	PHYSICIAN INDIVIDUAL NPI
3	1841261989	OTHER	AZ	GROUP NPI
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023089158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS RAYMOND ABRAM MD

Provider Business Mailing Address
First Line	:	1615 W FAIRWAY PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85737-8928
Country	:	US
Telephone Number	:	520-297-7046
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 W FAIRWAY PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85737-8928
Country	:	US
Telephone Number	:	520-297-7046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	03/18/2013

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Directions to “ THOMAS RAYMOND ABRAM MD” Practice Location

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