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General NPI Number Information
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NPI Number | 1114136207
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Entity Type | Individual
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Provider Name | HARRY MAISEL MD.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 6052 COCHISE DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2359
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Country | US
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Telephone | 313-560-8609
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Fax | 313-577-3125
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Provider Business Mailing Address
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Address Line | 6052 COCHISE DR
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2359
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Country | US
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Telephone | 313-560-8609
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Fax | 313-577-3125
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301027452
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License Number State | MI
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