Individual provider · NPI-1

Peter Voss Abraham, D.O.

Family Medicine · Eagle, ID

NPI number1043650633
StatusActive
Last updated in NPPESDec 14, 2016

Details

NPI
1043650633
Entity type
Individual (NPI-1)
Name
Mr. Peter Voss Abraham
Credential
D.O.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 27, 2013
Last updated
Dec 14, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineO-0988IDYes
207Q00000X Family Medicine7859AK

Practice location

507 S Fitness Pl
Suite 110
Eagle, ID 83616-6552

Phone 208-947-0925 · Fax 208-947-0926

Mailing address

507 S Fitness Pl
Suite 110
Eagle, ID 83616-6552

Phone 208-947-0925 · Fax 208-947-0926

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