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General NPI Number Information
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NPI Number | 1124009659
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Entity Type | Individual
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Provider Name | ABDI VAEZY MD
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Gender | Male
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Dates
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Enumeration Date | 11/10/2005
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 14949 N US HIGHWAY 25 E SUITE 6
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City | CORBIN
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State | KY
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Zip | 40701-6285
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Country | US
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Telephone | 606-528-0009
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Fax | 606-528-0091
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Provider Business Mailing Address
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Address Line | PO BOX 1325
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City | CORBIN
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State | KY
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Zip | 40702-1325
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Country | US
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Telephone | 606-526-8131
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Fax | 606-528-8661
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25857
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License Number State | KY
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