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1942293832

NPI Code Detail

MEDICARE: JOHN M ABRAN MD

MEDICARE: JOHN M ABRAN 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	01052573A	IN
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	186385	OTHER	IN	BCBS
2	0859423001	OTHER	IN	CIGNA
3	5259830	OTHER	IN	CCN
4	01630255	OTHER	IL	BCBC

General Provider Information

NPI Number	:	1942293832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M ABRAN MD

Provider Business Mailing Address
First Line	:	113 E 4TH ST
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-3301
Country	:	US
Telephone Number	:	219-873-3130
Fax Number	:	219-873-3132

Provider Business Practice Location Address
First Line	:	1423 CHICAGO RD
Second Line	:
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-3400
Country	:	US
Telephone Number	:	708-756-1000
Fax Number	:

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	04/16/2008

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Directions to “ JOHN M ABRAN MD” Practice Location

Language	Start Address	Practice Location

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