Provider Demographics
NPI:1427884584
Name:ABERCRUMBIE, FRED IV
Entity type:Individual
Prefix:MR
First Name:FRED
Middle Name:
Last Name:ABERCRUMBIE
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 E 57TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3306
Mailing Address - Country:US
Mailing Address - Phone:216-327-2368
Mailing Address - Fax:
Practice Address - Street 1:3719 E 57TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-3306
Practice Address - Country:US
Practice Address - Phone:216-327-2368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide