Provider Demographics
NPI:1497934657
Name:ABRAHAM, JOSEPH M (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:ABRAHAM
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 1:3320 N. HWY 81
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3626
Mailing Address - Country:US
Mailing Address - Phone:864-231-0235
Mailing Address - Fax:864-231-9559
Practice Address - Street 1:3320 N. HWY 81
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3626
Practice Address - Country:US
Practice Address - Phone:864-231-0235
Practice Address - Fax:864-231-9559
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC34406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1497934657OtherNPPES