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General NPI Number Information
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NPI Number | 1083882401
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Entity Type | Organization
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Legal Business Name | MOHAN PERSAUD MD PA
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 2051 45TH ST SUITE 104
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2027
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Country | US
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Telephone | 561-881-0100
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Fax | 561-881-0099
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Provider Business Mailing Address
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Address Line | 2051 45TH ST SUITE 104
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-2027
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Country | US
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Telephone | 561-881-0100
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Fax | 561-881-0099
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAN PERSAUD
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Credential | MD
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Telephone | 561-881-0100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME59705
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License Number State | FL
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