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General NPI Number Information
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NPI Number | 1154322089
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Entity Type | Individual
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Provider Name | RAJENDRAPRASAD V MAKAM MD
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Gender | Male
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Dates
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Enumeration Date | 08/02/2005
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 1120 SE CARY PKWY STE 204
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City | CARY
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State | NC
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Zip | 27511
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Country | US
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Telephone | 919-854-0041
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Fax | 919-854-0049
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Provider Business Mailing Address
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Address Line | 1850 W ARLINGTON BLVD
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City | GREENVILLE
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State | NC
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Zip | 27834-5704
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Country | US
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Telephone | 252-413-6641
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Fax | 252-752-6600
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 200300064
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 200300064
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License Number State | NC
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