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General NPI Number Information
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NPI Number | 1164528972
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Entity Type | Organization
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Legal Business Name | LOVELACE HEALTH SYSTEM:PULMONARY DISEASE
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4801 MCMAHON BLVD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5090
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Country | US
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Telephone | 505-727-3100
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Fax | 505-727-3131
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Provider Business Mailing Address
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Address Line | 4801 MCMAHON BLVD NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-5090
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Country | US
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Telephone | 505-727-3100
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Fax | 505-727-3131
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Authorized Official
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Title or Position | CEO
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Name | HARRY MAGNES
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Credential | MD
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Telephone | 505-262-3085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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