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General NPI Number Information
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NPI Number | 1073304945
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Entity Type | Organization
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Legal Business Name | SHENANDOAH MEDICAL UNIVERSITY LLC
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Dates
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Enumeration Date | 05/13/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 401 N ROSEMARY AVE
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-4133
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Country | US
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Telephone | 561-223-9191
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 741424
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City | BOYNTON BEACH
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State | FL
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Zip | 33474-1424
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Country | US
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Telephone | 561-223-9191
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANIELLE FULLER
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Credential | MBS
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Telephone | 561-275-0427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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