Individual
JOHN L ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2740 N MAYFAIR AVE, SPRINGFIELD, MO 65803-5084
(417) 521-3925
(417) 521-6860
Mailing address
2740 N MAYFAIR AVE, SPRINGFIELD, MO 65803-5084
(417) 521-3925
(417) 521-6860
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD115778
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200079890A
—
OK
05
—
200374490A
—
KS
05
—
243419306
—
MO
Enumeration date
08/17/2006
Last updated
01/13/2020
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