Basic Information
| Provider Information | |||||||||
| NPI: | 1508827825 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABRAMS | ||||||||
| FirstName: | MARK | ||||||||
| MiddleName: | JEFFREY | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6035 FAIRVIEW RD | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282103256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7042953000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 200 S HERLONG AVE | ||||||||
| Address2: | SUITE A | ||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297323399 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033281864 | ||||||||
| FaxNumber: | 8033281865 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2006 | ||||||||
| LastUpdateDate: | 04/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 200001456 | NC | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | MD 19159 | SC | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 191599 | 05 | SC | MEDICAID | 738506 | 01 | NC | COVENTRY | OTHER | 01146093 | 01 | SC | AMERIGROUP COMMUNITY CARE | OTHER | 20040529 | 01 | SC | SELECT HEALTH OF SC/FIRST CHOICE | OTHER | 3150341 | 01 | AETNA | OTHER | C5520 | 01 | MEDCOST | OTHER | 152HJ | 01 | NC | BCBSNC | OTHER | 85378 | 01 | SC | CHC CARES OF SC | OTHER | 3108752 | 01 | MAMSI | OTHER | 773586 | 01 | SC | WELLCARE | OTHER | P00059548 | 01 | MEDICARE RR | OTHER |