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General NPI Number Information
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NPI Number | 1003800988
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Entity Type | Individual
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Provider Name | GEORGE M MASSOUD MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 04/20/2018
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Provider Practice Location Address
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Address Line | 2559 N SCENIC DR SUITE F
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City | ALAMOGORDO
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State | NM
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Zip | 88310
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Country | US
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Telephone | 575-434-3225
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Fax | 575-434-8671
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Provider Business Mailing Address
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Address Line | 2579 NORTH SCENIC DRIVE
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City | ALAMOGORDO
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State | NM
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Zip | 88310-9740
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Country | US
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Telephone | 575-434-3225
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD38877
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 23341
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2003-0490
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License Number State | NM
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