Provider Demographics
NPI:1376938514
Name:ABRAHAM, ANN ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:ALEXANDER
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 W MOUNT ROYAL AVE UNIT 655
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-5567
Mailing Address - Country:US
Mailing Address - Phone:516-713-6337
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 7060
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2327
Practice Address - Country:US
Practice Address - Phone:509-474-5437
Practice Address - Fax:509-227-7070
Is Sole Proprietor?:No
Enumeration Date:2015-04-04
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD860882080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology