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General NPI Number Information
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NPI Number | 1063744969
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Entity Type | Organization
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Legal Business Name | PHYSICIANS VEIN CARE, PLLC
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 43184 DEQUINDRE RD SUITE 202
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-1709
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Country | US
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Telephone | 586-997-0999
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Fax | 586-997-0990
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Provider Business Mailing Address
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Address Line | 36500 FORD RD STE 212
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City | WESTLAND
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State | MI
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Zip | 48185-3769
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Country | US
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Telephone | 586-997-0999
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Fax | 586-997-0990
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Authorized Official
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Title or Position | OWNER
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Name | DR. RACHEL F SUSSMAN
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Credential | D.O.
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Telephone | 586-997-0999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | MI
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