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General NPI Number Information
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NPI Number | 1194970350
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Entity Type | Individual
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Provider Name | JOHN A VAN DOORNINCK MD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 01/31/2022
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Provider Practice Location Address
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Address Line | 2055 N HIGH ST #340
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City | DENVER
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State | CO
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Zip | 80205-5503
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Country | US
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Telephone | 303-832-2344
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Fax | 303-832-3721
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Provider Business Mailing Address
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Address Line | 4900 S MONACO ST SUITE 210
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City | DENVER
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State | CO
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Zip | 80237-3486
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Country | US
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Telephone | 303-832-2344
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Fax | 303-832-3721
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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 | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | A80230
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | 48641
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License Number State | CO
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