Provider Demographics
NPI:1467448761
Name:ABELL, DAVID B (PA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:B
Last Name:ABELL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BETHEL LANE
Mailing Address - Street 2:
Mailing Address - City:HARWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20776
Mailing Address - Country:US
Mailing Address - Phone:410-867-8538
Mailing Address - Fax:410-867-7636
Practice Address - Street 1:5 BETHEL LANE
Practice Address - Street 2:
Practice Address - City:HARWOOD
Practice Address - State:MD
Practice Address - Zip Code:20776
Practice Address - Country:US
Practice Address - Phone:410-867-8538
Practice Address - Fax:410-867-7636
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0002177363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD970017220OtherRAILROAD MEDICARE MEDICARE PIN
MD970017220OtherRAILROAD MEDICARE MEDICARE PIN
MD$$$$$$$$$OtherTRICARE CHAMPUS
MDK72742UUMedicare PIN