Provider Demographics
NPI:1598763393
Name:ABRAMS, MARC A (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:A
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 E 22ND ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-3176
Mailing Address - Country:US
Mailing Address - Phone:216-937-2020
Mailing Address - Fax:216-937-2145
Practice Address - Street 1:2322 E 22ND ST
Practice Address - Street 2:SUITE 102
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3176
Practice Address - Country:US
Practice Address - Phone:216-937-2020
Practice Address - Fax:216-937-2145
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2010-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-046932174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0597680Medicaid
OH0597680Medicaid
OH4109800001Medicare NSC
OHAB9315021Medicare ID - Type Unspecified