Provider Demographics
NPI:1245321728
Name:ABRAMS, MICHAEL BRAD (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRAD
Last Name:ABRAMS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 PONDFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-5222
Mailing Address - Country:US
Mailing Address - Phone:603-674-2502
Mailing Address - Fax:
Practice Address - Street 1:217 FISHERVILLE RD
Practice Address - Street 2:
Practice Address - City:PENACOOK
Practice Address - State:NH
Practice Address - Zip Code:03303-2074
Practice Address - Country:US
Practice Address - Phone:603-758-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH0758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist