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General NPI Number Information
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NPI Number | 1144464587
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Entity Type | Individual
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Provider Name | JOHN F MAYNARD M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | METACOMET OFFICE PARK 450 VETERANS PARKWAY
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914
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Country | US
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Telephone | 401-435-8486
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Fax |
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Provider Business Mailing Address
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Address Line | 20 DUNDEE CIR
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City | HARWICH
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State | MA
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Zip | 02645-3389
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Country | US
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Telephone | 401-435-8486
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 29309
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License Number State | MA
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