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General NPI Number Information
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NPI Number | 1144294406
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Entity Type | Individual
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Provider Name | ABDUL T RAZACK M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 3600 KOLBE RD SUITE 221
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City | LORAIN
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State | OH
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Zip | 44053-1652
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Country | US
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Telephone | 440-960-2718
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Fax | 440-960-5633
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Provider Business Mailing Address
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Address Line | P.O. BOX 364
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City | AMHERST
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State | OH
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Zip | 44001-0364
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Country | US
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Telephone | 440-960-2718
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Fax | 440-960-5633
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 64185
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License Number State | OH
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