MEDICARE: DAVID A ABBOTT MD

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	207R00000X	Internal Medicine Physician	MOMDR1G01	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568448850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID A ABBOTT MD

Provider Business Mailing Address
First Line	:	1035 BELLEVUE AVE
Second Line	:	SUITE 110
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1847
Country	:	US
Telephone Number	:	314-647-0180
Fax Number	:	314-647-1023

Provider Business Practice Location Address
First Line	:	1035 BELLEVUE AVE
Second Line	:	SUITE 110
City	:	RICHMOND HEIGHTS
State	:	MO
Zip	:	63117-1847
Country	:	US
Telephone Number	:	314-647-0180
Fax Number	:	314-647-1023

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	02/01/2018

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Directions to “ DAVID A ABBOTT MD” Practice Location

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