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General NPI Number Information
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NPI Number | 1114941507
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Entity Type | Individual
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Provider Name | LENORD SHYIA HORWITZ DPM
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 03/29/2011
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Provider Practice Location Address
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Address Line | 2135 COLLEGE AVENUE
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City | BLUEFIELD
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State | VA
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Zip | 24605
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Country | US
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Telephone | 276-322-5039
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Fax | 276-322-5396
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Provider Business Mailing Address
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Address Line | 135 FAWN CIRCLE
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City | BLUEFIELD
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State | VA
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Zip | 24605
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Country | US
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Telephone | 276-322-3601
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Fax | 276-322-2355
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0103000951
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License Number State | VA
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