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General NPI Number Information
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NPI Number | 1134771645
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Entity Type | Individual
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Provider Name | DANIYAH ALI ELAGI MD
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Gender | Female
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 12500 WILLOWBROOK RD
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City | CUMBERLAND
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State | MD
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Zip | 21502-6393
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Country | US
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Telephone | 806-414-9493
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Fax |
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Provider Business Mailing Address
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Address Line | 9450 FAIRFAX BLVD APT 1412
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City | FAIRFAX
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State | VA
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Zip | 22031-2418
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Country | US
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Telephone | 708-654-9177
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301510630
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License Number State | MI
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