MEDICARE: MICHAEL HOLGER ALBERT 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	10754	MS

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	1679562094	OTHER		NPI

General Provider Information

NPI Number	:	1679562094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HOLGER ALBERT MD

Provider Business Mailing Address
First Line	:	129 CENTER ST STE B
Second Line	:
City	:	RICHLAND
State	:	MS
Zip	:	39218-4800
Country	:	US
Telephone Number	:	769-233-7141
Fax Number	:	769-233-7726

Provider Business Practice Location Address
First Line	:	129 CENTER ST STE B
Second Line	:
City	:	RICHLAND
State	:	MS
Zip	:	39218-4800
Country	:	US
Telephone Number	:	692-337-1417
Fax Number	:	769-233-7726

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	04/25/2024

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