1821098344 NPI number — CYRIL ABRAMS M.D.

Table of content: CYRIL ABRAMS M.D. (NPI 1821098344)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821098344 NPI number — CYRIL ABRAMS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABRAMS
Provider First Name:
CYRIL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821098344
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 68
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POLLOCKSVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28573-0068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-938-3099
Provider Business Mailing Address Fax Number:
910-938-3243

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4275 WESTERN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSONVILLE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28546-1100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-938-3099
Provider Business Practice Location Address Fax Number:
910-938-3243
Provider Enumeration Date:
07/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  2003-00434 NC , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 89124HU , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: Q0043E , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01029258 . This is a "MEDICARE RR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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