Provider Demographics
NPI:1518944180
Name:JOSEPH, ABRAHAM K (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:K
Last Name:JOSEPH
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 1:1303 BUCHMAN RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3140
Mailing Address - Country:US
Mailing Address - Phone:419-334-8689
Mailing Address - Fax:
Practice Address - Street 1:410 BIRCHARD AVE
Practice Address - Street 2:BIRCHARD MEDICAL CENTER
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-2967
Practice Address - Country:US
Practice Address - Phone:419-334-4428
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35100254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0281789Medicaid
OH0281789Medicaid
OH0425225Medicare ID - Type Unspecified