Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01080132A | IN |
N | 207X00000X | Orthopaedic Surgeon | 4301104569 | MI |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 01080132A | IN |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 4301104569 | MI |
NPI | 1053579615 |
---|---|
Provider Name | Dr. Matthew David Abbott |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-2074 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 11/04/2018 |