Provider Demographics
NPI:1184773814
Name:ABGRAB, MICHAEL L (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:ABGRAB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 15TH ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1105
Mailing Address - Country:US
Mailing Address - Phone:508-674-5550
Mailing Address - Fax:
Practice Address - Street 1:29 15TH ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1105
Practice Address - Country:US
Practice Address - Phone:508-674-5550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1545111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36071OtherBLUE CROSS BLUE SHIELD MA
MA35616OtherHARVARD PILGRIM
MA44-00265OtherUNITED HEALTHCARE
RI3515-001OtherBLUE CROSS OF RI
RI401403OtherBLUE CHIP OF RI
RI401403OtherBLUE CHIP OF RI