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1588656953

NPI Code Detail

MEDICARE: ANDREW ROBERT ABOLINS MD

MEDICARE: ANDREW ROBERT ABOLINS 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	207Q00000X	Family Medicine Physician	MD00022909	WA

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
2	10437	OTHER	WA	L&I

General Provider Information

NPI Number	:	1588656953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ROBERT ABOLINS MD

Provider Business Mailing Address
First Line	:	PO BOX 98886
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98496-8886
Country	:	US
Telephone Number	:	253-581-3075
Fax Number	:	253-581-3178

Provider Business Practice Location Address
First Line	:	4905 108TH ST SW
Second Line	:
City	:	LAKEWOOD
State	:	WA
Zip	:	98499-3724
Country	:	US
Telephone Number	:	253-581-3075
Fax Number	:	253-581-3178

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

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	03/20/2014

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Directions to “ ANDREW ROBERT ABOLINS MD” Practice Location

Language	Start Address	Practice Location

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