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General NPI Number Information
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NPI Number | 1003884081
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Entity Type | Individual
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Provider Name | ALISAN G KULA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 7901 LAKE MANASSAS DR
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City | GAINESVILLE
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State | VA
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Zip | 20155-3257
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Country | US
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Telephone | 571-222-2200
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Fax | 571-222-2202
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Provider Business Mailing Address
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Address Line | 7901 LAKE MANASSAS DR
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City | GAINESVILLE
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State | VA
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Zip | 20155-3257
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Country | US
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Telephone | 571-222-2200
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Fax | 571-222-2202
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0101840419
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License Number State | VA
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