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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174511794 NPPES
Louisiana MEDICAID 1488909

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