Organization
ABBOTT MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VALERIE ABBOTT MD (OWNER)
(313) 341-4800
Entity
Organization
Contact information
Practice address
19830 JAMES COUZENS FWY, SUITE B, DETROIT, MI 48235-1938
(313) 341-4800
(313) 341-4848
Mailing address
PO BOX 44047, DETROIT, MI 48244-0047
(313) 341-4800
(313) 341-4848
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301060096
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H238930
BC GROUP
MI
05
—
4277758
—
MI
05
—
4583949
—
MI
01
—
614199100
DEPT OF LABOR
MI
Enumeration date
07/20/2005
Last updated
05/20/2009
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