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General NPI Number Information
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NPI Number | 1053415505
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Entity Type | Individual
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Provider Name | MICHAEL CONWAY MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 85 SEYMOUR STREET SUITE 923
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-547-1876
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Fax | 860-520-1379
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Provider Business Mailing Address
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Address Line | P.O. BOX 587
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City | ROCKY HILL
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State | CT
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Zip | 06067-0587
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Country | US
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Telephone | 860-258-3480
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Fax | 860-571-6800
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 018275
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License Number State | CT
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