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NPI 1043794159

NPI 1043794159 : MR. ABRAM MYERS : NEVADA CITY, CA

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General NPI Number Information
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    NPI Number           |    1043794159
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    Entity Type          |    Individual 
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    Provider Name        |    MR. ABRAM MYERS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/25/2018
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    Last Update Date     |    09/25/2018
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Provider Practice Location Address
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    Address Line         |    11505 VIA VIS 
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    City                 |    NEVADA CITY
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    State                |    CA
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    Zip                  |    95959-9639
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    Country              |    US
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    Telephone            |    530-615-8434
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    11505 VIA VIS 
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    City                 |    NEVADA CITY
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    State                |    CA
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    Zip                  |    95959-9639
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    Country              |    US
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    Telephone            |    530-615-8434
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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        |    172A00000X
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    Taxonomy Name        |    Driver
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    License Number       |    
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    License Number State |    CA
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