Healthcare Provider Details

I. General information

NPI: 1255387585
Provider Name (Legal Business Name): MATTHEW KARL ABELE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 10TH AVE S SUITE 501
BIRMINGHAM AL
35205-1200
US

IV. Provider business mailing address

2700 10TH AVE S SUITE 501
BIRMINGHAM AL
35205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-6890
  • Fax: 205-939-6895
Mailing address:
  • Phone: 205-939-6890
  • Fax: 205-939-6895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number17874
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number17874
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: