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General NPI Number Information
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NPI Number | 1093889420
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Entity Type | Organization
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Legal Business Name | POLARIS MEDICAL CARE
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Dates
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Enumeration Date | 11/18/2006
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 1327 CAMERON AVE
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City | LEWIS CENTER
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State | OH
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Zip | 43035-9662
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Country | US
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Telephone | 614-880-9540
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Fax | 614-410-1066
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Provider Business Mailing Address
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Address Line | 1327 CAMERON AVE
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City | LEWIS CENTER
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State | OH
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Zip | 43035-9662
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Country | US
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Telephone | 614-880-9540
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Fax | 614-410-1066
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT WOSKOBNICK
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Credential | DO
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Telephone | 614-880-9540
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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 |
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