Basic Information
| Provider Information | |||||||||
| NPI: | 1730129859 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABRAMSON | ||||||||
| FirstName: | SIMEON | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10700 E GEDDES AVE | ||||||||
| Address2: | #200 | ||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801123800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037619190 | ||||||||
| FaxNumber: | 7208744462 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 E HAMPDEN AVE | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD | ||||||||
| State: | CO | ||||||||
| PostalCode: | 801132702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037619190 | ||||||||
| FaxNumber: | 7208744462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 04/07/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 41619 | CO | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | MD17450 | HI | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 04-36694 | KS | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0202X | 24996 | NE | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 1730129859 | 05 | MT | MEDICAID | 1730129859 | 05 | IA | MEDICAID | 1730129859 | 05 | UT | MEDICAID | 2189037 | 05 | TX | MEDICAID | 407772780A | 05 | GA | MEDICAID | 920589 | 05 | AZ | MEDICAID | 10025709000 | 05 | NE | MEDICAID | C495218 | 05 | CO | MEDICAID | P00008724 | 01 | CO | MIC RR M'CARE | OTHER | XPY201210 | 05 | CA | MEDICAID | 104686015 | 05 | MI | MEDICAID | 200418400A | 05 | KS | MEDICAID | 57876738 | 05 | NM | MEDICAID | 84-059792913 | 05 | NE | MEDICAID | 7617657 | 05 | NC | MEDICAID | 1730129859/7726650 | 05 | SD | MEDICAID | 1730129859 | 05 | IL | MEDICAID | MD979CO | 05 | AK | MEDICAID | P00008544 | 01 | CO | RIA RR M'CARE | OTHER | 1730129859 | 05 | NV | MEDICAID | P00720361 | 01 | NE | RR MCR NE | OTHER | 118361300 | 05 | WY | MEDICAID | 28301811 | 05 | CO | MEDICAID |