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General NPI Number Information
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NPI Number | 1033478136
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Entity Type | Individual
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Provider Name | AEYAL RAZ M.D.,PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 1300 UNIVERSITY AVE ROOM 4605
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City | MADISON
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State | WI
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Zip | 53706-1510
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Country | US
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Telephone | 608-263-6662
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Fax |
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Provider Business Mailing Address
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Address Line | 207 EAGLE HTS APT. K
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City | MADISON
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State | WI
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Zip | 53705-1762
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Country | US
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Telephone | 608-515-0530
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 17763-875
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License Number State | WI
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