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General NPI Number Information
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NPI Number | 1134354012
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Entity Type | Individual
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Provider Name | MEGAN NICHOLE HEIL D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 07/30/2015
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Provider Practice Location Address
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Address Line | 1615 WINSTED DR
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City | GOSHEN
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State | IN
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Zip | 46526-4696
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Country | US
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Telephone | 574-533-8633
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Fax |
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Provider Business Mailing Address
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Address Line | 8084 E QUIET HARBOR DR
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City | SYRACUSE
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State | IN
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Zip | 46567-7522
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Country | US
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Telephone | 573-712-8929
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Fax |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 02004590A
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License Number State | IN
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