Basic Information
Provider Information
NPI: 1073047221
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABERCROMBIE
FirstName: MICHAEL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 743904
Address2:  
City: ATLANTA
State: GA
PostalCode: 303743904
CountryCode: US
TelephoneNumber: 8645228603
FaxNumber:  
Practice Location
Address1: 129 N WASHINGTON ST
Address2:  
City: SUMTER
State: SC
PostalCode: 291504949
CountryCode: US
TelephoneNumber: 8034346771
FaxNumber: 8034343955
Other Information
ProviderEnumerationDate: 04/14/2017
LastUpdateDate: 07/19/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/19/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X NCN Student, Health CareStudent in an Organized Health Care Education/Training Program 
208M00000X85649SCY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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