Provider Demographics
NPI:1659803237
Name:JOHN, BEULAH ABRAHAM (MD)
Entity type:Individual
Prefix:DR
First Name:BEULAH
Middle Name:ABRAHAM
Last Name:JOHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BEULAH
Other - Middle Name:ANNE
Other - Last Name:ABRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:41 UNIVERSITY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:610-772-6889
Mailing Address - Fax:
Practice Address - Street 1:1609 WOODBOURNE RD STE 101
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1520
Practice Address - Country:US
Practice Address - Phone:215-945-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-01
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD484068207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program