Individual
THOMAS RAYMOND ABRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1615 W FAIRWAY PL, TUCSON, AZ 85737-8928
(520) 297-7046
Mailing address
1615 W FAIRWAY PL, TUCSON, AZ 85737-8928
(520) 297-7046
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12516
AZ
2085U0001X
Diagnostic Ultrasound Physician
12516
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005472
GROUP MEDICAID ID
AZ
01
—
1023089158
PHYSICIAN INDIVIDUAL NPI
AZ
01
—
1841261989
GROUP NPI
AZ
05
—
295388
—
AZ
01
—
300024018
MEDICARE RAILROAD
AZ
01
—
CS7943
GROUP MEDICARE RAILROAD ID & PTAN
AZ
01
—
ZWCBBM
GROUP MEDICARE ID
AZ
Enumeration date
01/27/2006
Last updated
03/18/2013
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