Provider Demographics
NPI:1508178393
Name:MANUELA ABAD, TINTIN LLENA (MD)
Entity Type:Individual
Prefix:
First Name:TINTIN
Middle Name:LLENA
Last Name:MANUELA ABAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6297 BOULDER DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-3538
Mailing Address - Country:US
Mailing Address - Phone:810-877-1420
Mailing Address - Fax:
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:SON 5TH FLOOR
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-262-9773
Practice Address - Fax:810-262-7143
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096036208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301096036OtherSTATE LICENSE