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General NPI Number Information
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NPI Number | 1053570085
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Entity Type | Individual
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Provider Name | SRIRANGARAJAN RAJU MD
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Gender | Male
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Dates
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Enumeration Date | 06/05/2008
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Last Update Date | 04/23/2019
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Provider Practice Location Address
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Address Line | 1759 E VILLA DR
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4681
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Country | US
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Telephone | 289-235-8835
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Fax | 289-226-6411
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Provider Business Mailing Address
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Address Line | 2000 S THOMPSON ST
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-8759
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Country | US
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Telephone | 928-226-6439
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Fax | 928-226-6411
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | E8258
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 55671
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | E-8258
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License Number State | AR
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