Individual
DR. INGRID JULIE YEO CHUA-MANALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
46325 W. TWELVE MILE RD., STE. 100, NOVI, MI 48377-0000
(877) 784-3667
(248) 869-3982
Mailing address
29275 NORTHWESTERN HWY., STE. 100, SOUTHFIELD, MI 48034-0000
(877) 784-3667
(248) 869-3982
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
4301064281
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007272058
AETNA PIN
MI
05
—
4607165
—
MI
Enumeration date
11/06/2006
Last updated
12/17/2012
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