Basic Information
Provider Information
NPI: 1285130039
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOMBECK
FirstName: ABRAHAM
MiddleName: SYVERSEN
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 HOSPITAL RD
Address2:  
City: CHEROKEE
State: NC
PostalCode: 28719
CountryCode: US
TelephoneNumber: 8284976892
FaxNumber:  
Practice Location
Address1: 1 HOSPITAL RD
Address2:  
City: CHEROKEE
State: NC
PostalCode: 28719
CountryCode: US
TelephoneNumber: 8284976892
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/02/2018
LastUpdateDate: 07/22/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X2022-01722NCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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