Provider Demographics
NPI:1578317335
Name:OKOROR, ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:
Last Name:OKOROR
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 1:3803 OBSIDIAN DR
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-4211
Mailing Address - Country:US
Mailing Address - Phone:217-729-2184
Mailing Address - Fax:
Practice Address - Street 1:11 UPPER RIVERDALE ROAD
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274
Practice Address - Country:US
Practice Address - Phone:770-991-8026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program