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General NPI Number Information
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NPI Number | 1043390586
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Entity Type | Individual
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Provider Name | SHELLEY S MAGILL M.D., PH.D.
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Gender | Female
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | CDC, MYCOTIC DISEASES BRANCH 1600 CLIFTON ROAD, MAILSTOP C-09
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City | ATLANTA
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State | GA
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Zip | 30333
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Country | US
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Telephone | 404-639-3548
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Fax |
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Provider Business Mailing Address
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Address Line | 1432 MARKAN DR NE
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City | ATLANTA
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State | GA
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Zip | 30306-2305
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Country | US
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Telephone | 404-575-2170
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | D57343
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License Number State | MD
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