Provider Demographics
NPI:1467415521
Name:ABRAHAM, EAPEN K (M D)
Entity Type:Individual
Prefix:DR
First Name:EAPEN
Middle Name:K
Last Name:ABRAHAM
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LYTHAM CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5691
Mailing Address - Country:US
Mailing Address - Phone:410-642-2411
Mailing Address - Fax:410-642-1707
Practice Address - Street 1:BLDG 364 A, VA MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:PERRY POINT
Practice Address - State:MD
Practice Address - Zip Code:21902
Practice Address - Country:US
Practice Address - Phone:410-642-2411
Practice Address - Fax:410-642-1707
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00191772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry