Provider Demographics
NPI:1245522143
Name:ABRAHAM, REUBEN E (MD)
Entity type:Individual
Prefix:
First Name:REUBEN
Middle Name:E
Last Name:ABRAHAM
Suffix:
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 1:3401 BOX HILL CORPORATE CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1200
Mailing Address - Country:US
Mailing Address - Phone:410-671-0017
Mailing Address - Fax:
Practice Address - Street 1:3401 BOX HILL CORPORATE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1200
Practice Address - Country:US
Practice Address - Phone:410-671-0017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0077902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine