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General NPI Number Information
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NPI Number | 1174594816
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Entity Type | Individual
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Provider Name | SAMUEL M MAYERFIELD M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 3 CORWIN CT
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City | NEWBURGH
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State | NY
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Zip | 12550-5107
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Country | US
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Telephone | 845-561-1551
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Fax | 845-561-3269
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Provider Business Mailing Address
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Address Line | 445 CHESTNUT STREET
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City | UNION
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State | NJ
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Zip | 07083
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Country | US
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Telephone | 908-687-6054
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Fax | 908-686-7099
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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 | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 147116-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 147116-1
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License Number State | NY
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