Provider Demographics
NPI:1548235757
Name:AREEPHANTHU, ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:AREEPHANTHU
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 1:701 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4777
Mailing Address - Country:US
Mailing Address - Phone:843-383-5191
Mailing Address - Fax:843-339-4622
Practice Address - Street 1:701 MEDICAL PARK DR
Practice Address - Street 2:SUITE 302
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4777
Practice Address - Country:US
Practice Address - Phone:843-383-5191
Practice Address - Fax:843-339-4622
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18075207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG11994Medicare UPIN