Individual
BRUCE EUGENE ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7404 EXECUTIVE PL STE 503, LANHAM, MD 20706-6238
(240) 641-1052
Mailing address
7404 EXECUTIVE PL STE 503, LANHAM, MD 20706-6238
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0003799
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205548100
—
MD
Enumeration date
09/09/2008
Last updated
07/17/2023
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