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NPI Code Detail

MEDICARE: CHARLES ABRAHAM MD INC

MEDICARE: CHARLES ABRAHAM MD INC
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
1207Y00000XOtolaryngology PhysicianWV09147WV

General Provider Information

NPI Number : 1124162128
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHARLES ABRAHAM MD INC
Provider Business Mailing Address
First Line : 1231 6TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-2311
Country : US
Telephone Number : 304-522-1122
Fax Number :
Provider Business Practice Location Address
First Line : 1231 6TH AVE
Second Line :
City : HUNTINGTON
State : WV
Zip : 25701-2311
Country : US
Telephone Number : 304-522-1122
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : DR. CHARLES ABRAHAM
Credential : MD
Telephone Number : 304-522-1122
Provider Enumeration Date : 02/16/2007
Last Update Date : 02/15/2008

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