Provider Demographics
NPI:1225063829
Name:ABRAMS, JEROME L (MD)
Entity Type:Individual
Prefix:DR
First Name:JEROME
Middle Name:L
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1342 S GOVERNORS AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4804
Mailing Address - Country:US
Mailing Address - Phone:302-734-7796
Mailing Address - Fax:302-734-7758
Practice Address - Street 1:1342 S GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4804
Practice Address - Country:US
Practice Address - Phone:302-734-7796
Practice Address - Fax:302-734-7758
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10002113207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000047201Medicaid
DE0000047201Medicaid
DED01058Medicare UPIN