MEDICARE: DR. ABBAS A JOWKAR M.D.

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	2084N0600X	Clinical Neurophysiology Physician	4301096888	MI
2	2084N0400X	Neurology Physician	4301096888	MI
3	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	4301096888	MI
4	2084N0008X	Neuromuscular Medicine (Psychiatry & Neurology) Physician	236990	NC

General Provider Information

NPI Number	:	1760501662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABBAS A JOWKAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1848
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49443-1848
Country	:	US
Telephone Number	:	231-672-2120
Fax Number	:

Provider Business Practice Location Address
First Line	:	1675 LEAHY ST STE 401A
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49442-5547
Country	:	US
Telephone Number	:	231-672-4243
Fax Number	:	231-727-4214

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

Provider Enumeration Date	:	03/29/2007
Last Update Date	:	04/15/2025

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