Provider Demographics
NPI:1003813379
Name:ABRAMSON, PETER JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:JAY
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5673 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:STE 150
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1771
Mailing Address - Country:US
Mailing Address - Phone:404-297-1780
Mailing Address - Fax:404-252-7255
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD
Practice Address - Street 2:STE 150
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1771
Practice Address - Country:US
Practice Address - Phone:404-297-1780
Practice Address - Fax:404-252-7255
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038416207YX0905X, 207Y00000X, 207YS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000742541BMedicaid
GA1076855OtherFIRST HEALTH/AFFORDABLE
GA000742541CMedicaid
GA000742541PMedicaid
GA5621528OtherAETNA
GA52650571OtherBCBS OF GEORGIA
GA8807486OtherCIGNA
GA000742541EMedicaid
GA000742541CMedicaid
GA000742541CMedicaid