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Organization
GREGORIO MANABAT, MD MARISSA BATAYOLA, MD SC
Active
Organization
GREGORIO MANABAT, MD MARISSA BATAYOLA, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA L COLLINS (OFFICE MANAGER)
(815) 842-2893
Entity
Organization
Contact information
Practice address
1504 W REYNOLDS ST, SUITE C, PONTIAC, IL 61764-9779
(815) 842-2893
(815) 844-5960
Mailing address
1504 W REYNOLDS ST, SUITE C, PONTIAC, IL 61764-9779
(815) 842-2893
(815) 844-5960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
207R00000X
Internal Medicine Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315070
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/07/2008
Last updated
04/07/2008
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