Healthcare Provider Details

I. General information

NPI: 1578564639
Provider Name (Legal Business Name): MICHAEL DAVID ABRAMOFF MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-3938
  • Fax: 319-353-7699
Mailing address:
  • Phone: 319-356-3938
  • Fax: 319-353-7699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberSP165
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberSP165
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: