| Abbott Medical Group Pllc | |
|
19830 James Couzens Fwy Suite B Detroit MI 48235-1938 | |
| (313) 341-4800 | |
| (313) 341-4848 |
| Full Name | Abbott Medical Group Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 19830 James Couzens Fwy, Detroit, Michigan |
| Authorized Official Name and Position | Valerie Abbott (OWNER) |
| Authorized Official Contact | 3133414800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Abbott Medical Group Pllc Po Box 44047 Detroit MI 48244-0047 Ph: (313) 341-4800 | Abbott Medical Group Pllc 19830 James Couzens Fwy Suite B Detroit MI 48235-1938 Ph: (313) 341-4800 |
| NPI Number | 1659370724 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 05/20/2009 |
| Medicare PECOS PAC ID | 0840279394 |
|---|---|
| Medicare Enrollment ID | O20040717000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659370724 | NPI | - | NPPES |
| 4277758 | Medicaid | MI | |
| 4583949 | Medicaid | MI | |
| 110H238930 | Other | MI | BC GROUP |
| 110H238930 | Other | MI | BCN GROUP |
| 614199100 | Other | MI | DEPT OF LABOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 4301060096 (Michigan) | Primary |
| Provider Name | Valerie Y Abbott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740289487 PECOS PAC ID: 9830178383 Enrollment ID: I20040809000553 |
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