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General NPI Number Information
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NPI Number | 1154387074
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Entity Type | Individual
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Provider Name | AVEREL B SNYDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 07/12/2011
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Provider Practice Location Address
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Address Line | 5665 PEACHTREE DUNWOODY ROAD SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30342-1701
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Country | US
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Telephone | 404-252-6104
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Fax | 404-257-1808
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Provider Business Mailing Address
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Address Line | P.O. BOX 70547
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City | MARIETTA
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State | GA
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Zip | 30007-0547
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Country | US
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Telephone | 770-579-1894
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Fax | 770-579-1899
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 035769
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License Number State | GA
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