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General NPI Number Information
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NPI Number | 1023103041
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Entity Type | Individual
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Provider Name | PHILIP W CHAO M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/15/2012
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Provider Practice Location Address
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Address Line | 17252 N VILLAGE MAIN BLVD STE 9
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City | LEWES
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State | DE
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Zip | 19958-6292
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Country | US
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Telephone | 302-827-4251
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Fax | 302-827-4351
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Provider Business Mailing Address
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Address Line | 31286 PONDVIEW DR RED MILL MANOR
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City | LEWES
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State | DE
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Zip | 19958-3600
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Country | US
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Telephone | 302-827-4251
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Fax | 302-827-4351
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | C100003457
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License Number State | DE
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