Provider Demographics
NPI:1043650633
Name:ABRAHAM, PETER VOSS (DO)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:VOSS
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:507 S FITNESS PL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-6552
Mailing Address - Country:US
Mailing Address - Phone:208-947-0925
Mailing Address - Fax:208-947-0926
Practice Address - Street 1:507 S FITNESS PL
Practice Address - Street 2:SUITE 110
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-6552
Practice Address - Country:US
Practice Address - Phone:208-947-0925
Practice Address - Fax:208-947-0926
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2016-12-14
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Provider Licenses
StateLicense IDTaxonomies
AK7859207Q00000X
IDO-0988207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine