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General NPI Number Information
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NPI Number | 1154312445
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Entity Type | Individual
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Provider Name | PAUL R COLAVINCENZO M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 1625 DELCO PARK DR
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City | DAYTON
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State | OH
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Zip | 45420-1391
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Country | US
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Telephone | 937-293-8228
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Fax | 937-293-8228
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Provider Business Mailing Address
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Address Line | PO BOX 932759
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City | CLEVELAND
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State | OH
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Zip | 44193-1500
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Country | US
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Telephone | 937-293-8228
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Fax | 937-293-8229
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35056613
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License Number State | OH
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