Individual
DR. MATTHEW MACK ABRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 ASMA BLVD, SUITE 205, LAFAYETTE, LA 70508-3858
(337) 289-5605
(337) 289-5609
Mailing address
2851 JOHNSTON STREET, PMB 517, LAFAYETTE, LA 70503-3243
(337) 561-8508
(833) 561-2443
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
024082
LA
207QS1201X
Sleep Medicine (Family Medicine) Physician
Primary
024082
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1488909
—
LA
Enumeration date
10/07/2005
Last updated
11/16/2023
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