Andrea J Abatemarco, RD

Individual provider Active NPI Registered Dietitian · Detroit, MI

NPI 1104073162 · NPPES record last updated Aug 21, 2008

Key facts

NPI
1104073162
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
01024498 (IL)
Practice address
4201 Saint Antoine St
Uhc, Suite 5a
Detroit, MI 48201-2153
Phone
(313) 745-4525
NPI assigned
Aug 21, 2008
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
01024498ILMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
University Physician Group Past Accepting new patients
University Physician Group Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 01024498 IL Yes

Addresses

Primary practice location

4201 Saint Antoine St
Uhc, Suite 5a
Detroit, MI 48201-2153

Mailing address

3800 Woodward Ave
Suite 600
Detroit, MI 48201-2061

Other providers in Detroit, MI

All providers in Detroit, MI · Registered Dietitian in Michigan

Sources for this page

Verify at the official NPI Registry.