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General NPI Number Information
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NPI Number | 1073507828
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Entity Type | Individual
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Provider Name | GEORGE E MARTINEZ MD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 750 N COBB ST STE 120
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-2390
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Country | US
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Telephone | 478-452-5515
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Fax | 478-452-5517
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Provider Business Mailing Address
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Address Line | PO BOX 28650
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City | MACON
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State | GA
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Zip | 31221-8650
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Country | US
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Telephone | 478-452-5515
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Fax | 478-452-5517
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 047982
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License Number State | GA
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