MEDICARE: DR. ALBERT PATTERSON D.C.

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	111N00000X	Chiropractor	AP008377	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950D450300	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1437248275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALBERT PATTERSON D.C.

Provider Business Mailing Address
First Line	:	3702 HURON ST
Second Line	:	PO BOX 48
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461-8142
Country	:	US
Telephone Number	:	810-688-4891
Fax Number	:

Provider Business Practice Location Address
First Line	:	3702 HURON ST
Second Line	:	SUITE 1
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461-8142
Country	:	US
Telephone Number	:	810-688-4891
Fax Number	:

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

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	08/15/2012

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