Individual provider · NPI-1

John L Abraham, M.D.

Family Medicine · Springfield, MO

NPI number1760595136
StatusActive
Last updated in NPPESJan 13, 2020

Details

NPI
1760595136
Entity type
Individual (NPI-1)
Name
John L Abraham
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Aug 17, 2006
Certification date
Jan 13, 2020
Last updated
Jan 13, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineMD115778MOYes

Practice location

2740 N Mayfair Ave
Springfield, MO 65803-5084

Phone 417-521-3925 · Fax 417-521-6860

Mailing address

2740 N Mayfair Ave
Springfield, MO 65803-5084

Phone 417-521-3925 · Fax 417-521-6860

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