Manell Aboutaleb
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Jackson, MI
NPI 1609628981 · NPPES record last updated Apr 2, 2024
Key facts
- NPI
- 1609628981
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 205 N East Ave
Jackson, MI 49201-1753 - Phone
- (517) 205-4800
- NPI assigned
- Apr 2, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240827001548 | MI | Order and Referring Only - Family Practice |
8325587975 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Interoperability endpoints
- maboutaleb991677@direct.hfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
205 N East Ave
Jackson, MI 49201-1753
Mailing address
205 N East Ave
Jackson, MI 49201-1753
Other providers in Jackson, MI
- Abc Center for Learning Inc
- Amirreza Abdolmaleki
- Muhammad Abdullah
- Ashraf Shaaban Abdel Aziz Abou El Ela
- Iman S Abou-Chakra
- Emily Abraham
- Denise Claire Abrams
- Hiba Abu Suhaiban
- Sarah Lynn Ackerman
- Active Care Chiropractic Inc
All providers in Jackson, MI · Student in an Organized Health Care Education/Training Program in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.