Provider Demographics
NPI:1558467019
Name:ABRAMSON, TED DAVID (DC)
Entity Type:Individual
Prefix:
First Name:TED
Middle Name:DAVID
Last Name:ABRAMSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30160
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21270-0160
Mailing Address - Country:US
Mailing Address - Phone:410-486-2298
Mailing Address - Fax:410-358-6551
Practice Address - Street 1:6615 REISTERSTOWN RD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-2686
Practice Address - Country:US
Practice Address - Phone:410-486-2298
Practice Address - Fax:410-358-6551
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02026111N00000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD61039504OtherBLUECROSS BLUESHIELD
MDJ3600005OtherFEDERAL BCBS
MD61039504OtherBLUECROSS BLUESHIELD