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General NPI Number Information
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NPI Number | 1144261488
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Entity Type | Organization
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Legal Business Name | EXTENDED CARE MEDICAL ASSOC. PC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4748 S KNOLL CT
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City | W BLOOMFIELD
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State | MI
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Zip | 48323-2520
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Country | US
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Telephone | 248-681-1963
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Fax | 248-681-3524
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Provider Business Mailing Address
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Address Line | PO BOX 251642
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City | W BLOOMFIELD
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State | MI
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Zip | 48325-1642
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Country | US
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Telephone | 248-681-1963
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Fax | 248-681-3524
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. ARTHUR HAROLD
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Credential | DO
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Telephone | 248-681-1963
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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 | AH005640
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License Number State | MI
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