Provider Demographics
NPI:1225412794
Name:ABRAHAM, TERESA GEORGE (PHARMD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:GEORGE
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2003 MEDICAL PKWY STE G10
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3065
Mailing Address - Country:US
Mailing Address - Phone:443-481-5826
Mailing Address - Fax:
Practice Address - Street 1:2003 MEDICAL PKWY STE G10
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3065
Practice Address - Country:US
Practice Address - Phone:443-481-5826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-15
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY059691183500000X
MD271381835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist