Paul Allan Abraham, MD
Individual provider Active NPI Nephrology Physician · St Paul, MN
NPI 1477528438 · NPPES record last updated Aug 14, 2008
Key facts
- NPI
- 1477528438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 22591 (MN)
- Practice address
- 401 Phalen Blvd
Mail Stop 41103C
St Paul, MN 55101-5302 - Phone
- (651) 254-7850
- Fax
- (651) 254-7857
- NPI assigned
- Feb 22, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22591 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| West Side Community Health Services, Inc. | Current |
Accepting new patients | |
| West Side Community Health Services, Inc. | Current |
Accepting new patients | |
| Regions Hospital | Past | Accepting new patients |
Locations
895 7th St E
Saint Paul, MN 55106
Phone (651) 793-2250
153 Cesar Chavez St
West Saint Paul, MN 55107
Phone (651) 222-1816
Interoperability endpoints
- pabraham732981@direct.ochin.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 22591 | MN | Yes |
Addresses
Primary practice location
401 Phalen Blvd
Mail Stop 41103C
St Paul, MN 55101-5302
Mailing address
401 Phalen Blvd
Ms 41103C
Saint Paul, MN 55130-5302
Phone (651) 254-7850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 043870700 | Medicaid | MN |
Other names
- Paul Abraham
Other providers in St Paul, MN
- Mohamed Abou-Karam
- Taslima Aboubaker
- Above All Therapy LLC
- Brenda Louise Wilcox Abraham
- Dawn Abraham
- Quinnita Abraham
- Susan Abraham
- Abrahams Bosom Care LLC
- George Abrahams
- Ajaia Suri Abramson
All providers in St Paul, MN · Nephrology Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.