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General NPI Number Information
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NPI Number | 1073508669
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Entity Type | Individual
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Provider Name | BARTHOLOMEW ANDREW MARTYAK MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 04/14/2010
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Provider Practice Location Address
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Address Line | 3417 BUSCH ST
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City | BUTTE
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State | MT
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Zip | 59701-3505
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Country | US
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Telephone | 406-541-3937
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Fax | 406-541-1810
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Provider Business Mailing Address
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Address Line | PO BOX 4907 700 WEST KENT
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City | MISSOULA
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State | MT
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Zip | 59806-4907
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Country | US
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Telephone | 406-541-3937
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Fax | 406-541-1810
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 7395
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License Number State | MT
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