Provider Demographics
NPI:1407826787
Name:ABRAHAMS, ROGER A (MD)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:A
Last Name:ABRAHAMS
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 1:1000 MON HEALTH MEDICAL PARK DR STE 1102
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1143
Mailing Address - Country:US
Mailing Address - Phone:304-598-2801
Mailing Address - Fax:304-599-6463
Practice Address - Street 1:1100 MON HEALTH MEDICAL PARK DR STE1102
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-598-2801
Practice Address - Fax:304-599-6463
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV14486207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0084708000Medicaid
WV444012430OtherRAILROAD MEDICARE
WV0084708000Medicaid
WVB74322Medicare UPIN