Provider Demographics
NPI:1417949751
Name:ABSHER, JOHN ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ROBERT
Last Name:ABSHER
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 1:155 HALTON RD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-3507
Mailing Address - Country:US
Mailing Address - Phone:864-286-8222
Mailing Address - Fax:864-286-3356
Practice Address - Street 1:155 HALTON RD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3507
Practice Address - Country:US
Practice Address - Phone:864-286-8222
Practice Address - Fax:864-286-3356
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2021-09-30
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-04-19
Provider Licenses
StateLicense IDTaxonomies
NC355732084N0400X
SC211162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC130021519OtherRAILROAD MEDICARE
SC211167Medicaid
SC7267Medicare PIN
SC130021519OtherRAILROAD MEDICARE
SC130021519OtherRAILROAD MEDICARE