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General NPI Number Information
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NPI Number | 1124155833
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Entity Type | Organization
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Legal Business Name | MOHCI
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6900 ENGLISH AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-7416
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Country | US
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Telephone | 317-352-4333
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Fax | 317-352-4032
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Provider Business Mailing Address
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Address Line | 20 GRAPEVINE CT
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City | W LAFAYETTE
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State | IN
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Zip | 47906-9047
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | STAFF PHYSICIAN
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Name | DR. SALIGRAMA ANJANIGOWDA RANGANATH
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Credential | MD
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Telephone | 317-352-4333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 01040697A
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License Number State | IN
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