Provider Demographics
NPI:1710008222
Name:ABRAMS, ROBERT E (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:E
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 REMINGTON CT
Mailing Address - Street 2:
Mailing Address - City:CHINA
Mailing Address - State:MI
Mailing Address - Zip Code:48054-2156
Mailing Address - Country:US
Mailing Address - Phone:586-596-0348
Mailing Address - Fax:
Practice Address - Street 1:30800 LITTLE MACK RD.
Practice Address - Street 2:MEIJER PHCY
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066
Practice Address - Country:US
Practice Address - Phone:586-415-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0460780051Medicare ID - Type Unspecified