Provider Demographics
NPI:1942815915
Name:ABBOTT, MICHAEL JAMES II (PA-C)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:ABBOTT
Suffix:II
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:138 PEAR ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:MOON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:15108-3828
Mailing Address - Country:US
Mailing Address - Phone:412-862-7752
Mailing Address - Fax:
Practice Address - Street 1:4815 LIBERTY AVE STE 156
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-4230
Practice Address - Fax:412-235-5878
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA061839363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical