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NPI Code Detail

MEDICARE: DR. B ABRAHAM PC

MEDICARE: DR. B ABRAHAM PC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1104826775
Entity Type Code : Organization
Provider Name (Legal Business Name) : DR. B ABRAHAM PC
Provider Business Mailing Address
First Line : 3020 HIGHWAY 124
Second Line :
City : SNELLVILLE
State : GA
Zip : 30039-4614
Country : US
Telephone Number : 770-978-1331
Fax Number : 770-978-8580
Provider Business Practice Location Address
First Line : 3020 HIGHWAY 124
Second Line :
City : SNELLVILLE
State : GA
Zip : 30039-4614
Country : US
Telephone Number : 770-978-1331
Fax Number : 770-978-8580
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : STEPHANIE BREEN
Credential :
Telephone Number : 770-978-1331
Provider Enumeration Date : 07/26/2005
Last Update Date : 01/26/2026

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