Physician Compare National (NPI:1144208232)

HEALTHCARE PROVIDER: JACQUELINE F FABELLO-GAMIAO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1144208232
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375596216
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050302000953
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FABELLO GAMIAO
	Individual professional last name
Provider First Name	JACQUELINE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	37650 PROFESSIONAL CTR DR
	Group Practice or individual's line 1 address
Line 2 Street Address	100A
	Group Practice or individual's line 2 address
City	LIVONIA
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	481541199
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230002
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY MERCY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230020
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BEAUMONT HOSPITAL - DEARBORN
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230046
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	UNIVERSITY OF MICHIGAN HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	230130
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BEAUMONT HOSPITAL, ROYAL OAK
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	230151
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	BEAUMONT HOSPITAL - FARMINGTON HILLS
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1144208232)

HEALTHCARE PROVIDER: JACQUELINE F FABELLO-GAMIAO MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information