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General NPI Number Information
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NPI Number | 1134227721
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE FAMILY MEDICAL CARE,PC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 12/18/2009
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Provider Practice Location Address
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Address Line | 120 MAPLE ST SUITE 203
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City | SPRINGFIELD
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State | MA
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Zip | 01103-2203
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Country | US
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Telephone | 413-733-7900
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Fax | 413-733-7905
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Provider Business Mailing Address
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Address Line | PO BOX 10417
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City | HOLYOKE
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State | MA
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Zip | 01041-2017
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Country | US
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Telephone | 413-540-0150
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Fax | 413-540-0159
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Authorized Official
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Title or Position | OWNER
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Name | DR. MARTIN HERNANDEZ BEM
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Credential | MD
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Telephone | 413-733-7900
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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 | 35779
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License Number State | MA
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