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General NPI Number Information
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NPI Number | 1184753584
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Entity Type | Individual
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Provider Name | STEVEN EUGENE MARTINSON RPH
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Gender | Male
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Dates
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Enumeration Date | 03/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 950 S MULFORD RD
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City | ROCKFORD
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State | IL
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Zip | 61108-4274
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Country | US
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Telephone | 815-381-8541
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Fax | 815-484-0918
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Provider Business Mailing Address
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Address Line | 1715 12TH AVE
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City | BELVIDERE
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State | IL
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Zip | 61008-5831
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Country | US
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Telephone | 815-566-5300
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State | IL
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