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General NPI Number Information
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NPI Number | 1184867160
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Entity Type | Individual
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Provider Name | DENNIS BRUCE KOLARIK D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 2221 9TH ST SW
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City | CANTON
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State | OH
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Zip | 44706-1464
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Country | US
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Telephone | 330-455-3663
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Fax |
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Provider Business Mailing Address
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Address Line | 7344 BARCLAY CT
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City | UNIVERSITY PARK
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State | FL
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Zip | 34201-2340
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Country | US
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Telephone | 941-351-2527
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1978
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License Number State | OH
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