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General NPI Number Information
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NPI Number | 1043452659
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Entity Type | Individual
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Provider Name | CHRISTOPHER GEORGE WLADYKA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 02/14/2024
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Provider Practice Location Address
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Address Line | 2025 MORSE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95825-2115
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Country | US
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Telephone | 916-817-5250
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Fax |
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Provider Business Mailing Address
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Address Line | 422 JARDIN PL
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City | DAVIS
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State | CA
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Zip | 95616-0234
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Country | US
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Telephone | 202-262-8459
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A119260
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License Number State | CA
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