Provider Demographics
NPI:1215376108
Name:ABRAHAM, TINA ELIZABETH (DO)
Entity type:Individual
Prefix:DR
First Name:TINA
Middle Name:ELIZABETH
Last Name:ABRAHAM
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Gender:F
Credentials:DO
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Mailing Address - Street 1:50 N PERRY ST
Mailing Address - Street 2:FADI SALLOUM, MD, PC
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48342-2217
Mailing Address - Country:US
Mailing Address - Phone:248-338-5645
Mailing Address - Fax:248-338-5547
Practice Address - Street 1:50 N PERRY ST
Practice Address - Street 2:FADI SALLOUM, MD, PC
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48342-2217
Practice Address - Country:US
Practice Address - Phone:248-338-5645
Practice Address - Fax:248-338-5547
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2016-10-25
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Provider Licenses
StateLicense IDTaxonomies
MI5101020319207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine