Provider Demographics
NPI:1891088985
Name:ABISOGUN, ABBY TUBMAN (MD)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:TUBMAN
Last Name:ABISOGUN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7505 WATERS AVE STE A9
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3817
Mailing Address - Country:US
Mailing Address - Phone:912-483-9313
Mailing Address - Fax:912-446-0549
Practice Address - Street 1:7505 WATERS AVE STE A9
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3817
Practice Address - Country:US
Practice Address - Phone:912-483-9313
Practice Address - Fax:912-446-0549
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-23
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP02225207R00000X
NC2016-00460207RE0101X
GA080802207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine