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General NPI Number Information
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NPI Number | 1194717454
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Entity Type | Individual
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Provider Name | JOHN CHARLES ANDREOZZI MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 2600 SIXTH ST SW FL 6
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City | CANTON
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State | OH
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Zip | 44710-1702
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Country | US
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Telephone | 308-303-3933
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Fax | 234-521-7091
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Provider Business Mailing Address
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Address Line | 3325 SUMSER ST NW
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City | NORTH CANTON
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State | OH
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Zip | 44720-7954
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Country | US
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Telephone | 330-499-7219
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Fax | 330-588-2216
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 35038342
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License Number State | OH
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