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General NPI Number Information
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NPI Number | 1003092347
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Entity Type | Individual
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Provider Name | ANINDITA DEVANATH M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 01/17/2008
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Provider Practice Location Address
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Address Line | 1364 CLIFTON RD NE # H185A
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City | ATLANTA
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State | GA
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Zip | 30322-1059
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Country | US
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Telephone | 404-712-8210
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 CLAIRMONT RD NE APT 1407
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City | ATLANTA
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State | GA
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Zip | 30329-4441
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Country | US
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Telephone | 404-308-3428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 002645
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License Number State | GA
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