Provider Demographics
NPI:1902010986
Name:ABRAHAM, WADIE HILL II (MD)
Entity Type:Individual
Prefix:
First Name:WADIE
Middle Name:HILL
Last Name:ABRAHAM
Suffix:II
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 1:2373 HIGHWAY 11 AND 80
Mailing Address - Street 2:
Mailing Address - City:TOOMSUBA
Mailing Address - State:MS
Mailing Address - Zip Code:39364-9441
Mailing Address - Country:US
Mailing Address - Phone:601-483-7086
Mailing Address - Fax:
Practice Address - Street 1:2373 HIGHWAY 11 AND 80
Practice Address - Street 2:
Practice Address - City:TOOMSUBA
Practice Address - State:MS
Practice Address - Zip Code:39364-9441
Practice Address - Country:US
Practice Address - Phone:601-483-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05081207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology