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NPI Code Detail

MEDICARE: SUZANNE ABRAHAM

MEDICARE: SUZANNE ABRAHAM
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
1213E00000XPodiatrist609AZ

General Provider Information

NPI Number : 1699727065
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUZANNE ABRAHAM
Provider Business Mailing Address
First Line : 8390 E VIA DE VENTURA STE F110
Second Line : #247
City : SCOTTSDALE
State : AZ
Zip : 85258-3189
Country : US
Telephone Number : 480-596-3309
Fax Number : 602-697-3912
Provider Business Practice Location Address
First Line : 2000 W BETHANY HOME RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-2443
Country : US
Telephone Number : 480-596-3309
Fax Number : 602-697-3912
Authorized Official
Title or Position : OWNER
Name : SUZANNE ABRAHAM
Credential :
Telephone Number : 480-596-3309
Provider Enumeration Date : 05/16/2006
Last Update Date : 08/22/2020

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