MEDICARE: MR. MAX JOSEPH ABELMAN M. A., L. L. P.

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	103T00000X	Psychologist	6301013633	MI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1346433505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAX JOSEPH ABELMAN M. A., L. L. P.

Provider Business Mailing Address
First Line	:	3815 W FORT ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1652
Country	:	US
Telephone Number	:	313-841-7380
Fax Number	:	313-841-3730

Provider Business Practice Location Address
First Line	:	3815 W FORT ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1652
Country	:	US
Telephone Number	:	313-841-7380
Fax Number	:	313-841-3730

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

Provider Enumeration Date	:	08/21/2007
Last Update Date	:	02/12/2009

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