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General NPI Number Information
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NPI Number | 1013973676
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Entity Type | Individual
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Provider Name | CHARUWAN SIRI M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 11/28/2012
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Provider Practice Location Address
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Address Line | 308 N 4TH AVE
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City | HOPEWELL
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State | VA
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Zip | 23860-2506
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Country | US
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Telephone | 804-541-8812
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Fax | 804-541-1396
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Provider Business Mailing Address
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Address Line | 10479 JORDAN PKWY
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City | HOPEWELL
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State | VA
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Zip | 23860-8271
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Country | US
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Telephone |
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101032006
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License Number State | VA
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