Provider Demographics
NPI:1982697306
Name:ABELLA, ESTEBAN M (MD)
Entity Type:Individual
Prefix:
First Name:ESTEBAN
Middle Name:M
Last Name:ABELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1432 S DOBSON RD
Mailing Address - Street 2:STE 107
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-4768
Mailing Address - Country:US
Mailing Address - Phone:480-833-1123
Mailing Address - Fax:480-833-1124
Practice Address - Street 1:1432 S DOBSON RD
Practice Address - Street 2:STE 107
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-4768
Practice Address - Country:US
Practice Address - Phone:480-833-1123
Practice Address - Fax:480-833-1124
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ321252080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ820945Medicaid
AZ820945Medicaid
AZ77061Medicare ID - Type UnspecifiedINDIVIDUAL