Individual
GEORGE ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1907 MISSION 66, VICKSBURG, MS 39180-3711
(601) 619-3838
Mailing address
1907 MISSION 66, VICKSBURG, MS 39180-3711
(601) 619-3838
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
07276
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0114239
—
MS
05
—
1189677
—
LA
01
—
4578402
AETNA
MS
Enumeration date
06/18/2006
Last updated
10/28/2008
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