Basic Information
| Provider Information | |||||||||
| NPI: | 1700827300 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABRAHAM | ||||||||
| FirstName: | FRANCIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 701 DELLWOOD ST S | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550081920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7636898700 | ||||||||
| FaxNumber: | 7636897816 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 DELLWOOD ST S | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550081920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7636898700 | ||||||||
| FaxNumber: | 7636887941 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2006 | ||||||||
| LastUpdateDate: | 03/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 03/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 24293 | OK | N | Other Service Providers | Specialist | 208600000X | 37713 | MN | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 200051550A | 05 | OK | MEDICAID |