Physician Compare National (NPI:1215376108)

HEALTHCARE PROVIDER: TINA ELIZABETH ABRAHAM D.O.

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

Individual Professional Information
NPI	1215376108
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416199583
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161109000294
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ABRAHAM
	Individual professional last name
Provider First Name	TINA
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	ALLERGY/IMMUNOLOGY
	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	1083 SUNCREST DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	LAPEER
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	484464421
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230193
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MCLAREN LAPEER REGION
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230254
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CRITTENTON HOSPITAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y