Provider Demographics
NPI:1467654293
Name:ABRAHAM, ELIZABETH CHATHAPARAMPIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CHATHAPARAMPIL
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 1:7387 WATSON RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63119-4405
Mailing Address - Country:US
Mailing Address - Phone:314-500-5437
Mailing Address - Fax:
Practice Address - Street 1:7387 WATSON RD STE 310
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63119-4405
Practice Address - Country:US
Practice Address - Phone:314-500-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57008703146D00000X
OH57.0087032080P0210X
MO2010013751208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology