MEDICARE: ABIGAIL MEDICAL FAMILY MEDICINE, L.L.C.

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	207Q00000X	Family Medicine Physician	C20005526	DE

General Provider Information

NPI Number	:	1922134899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABIGAIL MEDICAL FAMILY MEDICINE, L.L.C.

Provider Business Mailing Address
First Line	:	412 SUBURBAN DR
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-3564
Country	:	US
Telephone Number	:	302-738-3770
Fax Number	:	302-738-4749

Provider Business Practice Location Address
First Line	:	412 SUBURBAN DR
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19711-3564
Country	:	US
Telephone Number	:	302-738-3770
Fax Number	:	302-738-4749

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MR. JAMES CLARK HORAH
Credential	:
Telephone Number	:	302-738-3770

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	10/13/2016

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