MEDICARE: DR. MARTIN M ABBRECHT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	4301024847	MI

General Provider Information

NPI Number	:	1326038076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN M ABBRECHT MD

Provider Business Mailing Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 101
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-646-9597
Fax Number	:	248-646-4067

Provider Business Practice Location Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 101
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-646-9597
Fax Number	:	248-646-4067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	10/22/2007

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