Abraham, Matthew Mack
Abraham, Matthew Mack is an sole proprietor health care provider with primary practice located at 100 Asma Blvd Suite 205, Lafayette LA 70508-3858. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Abraham, Matthew Mack can be contacted via phone (337) 289-5605.Contact Information
Primary practice address
100 Asma Blvd Suite 205
Lafayette LA 70508-3858
Phone: (337) 289-5605
Fax: (337) 289-5609
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 024082 | Louisiana |
Allopathic & Osteopathic Physicians / Sleep Medicine | 207QS1201X | 024082 | Louisiana |
Profile Details
NPI number | 1174511794 |
---|---|
LBN Legal business name | Abraham, Matthew Mack |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Oct 7th, 2005 |
Last updated | Nov 16th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1174511794 | NPPES |
Louisiana | MEDICAID | 1488909 |
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