Provider Demographics
NPI:1083036909
Name:ABRAMS, WILLIAM MICHAEL (LDO)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 E TUDOR RD STE 5
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1036
Mailing Address - Country:US
Mailing Address - Phone:615-243-2150
Mailing Address - Fax:
Practice Address - Street 1:1515 E TUDOR RD
Practice Address - Street 2:SUITE 5
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-1035
Practice Address - Country:US
Practice Address - Phone:907-770-7747
Practice Address - Fax:907-770-7747
Is Sole Proprietor?:No
Enumeration Date:2014-01-12
Last Update Date:2014-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK328156FX1800X
FL2147156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician