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NPI 1205984747

NPI 1205984747 : NICHOLAS CAMPANELLA DC : BEL AIR, MD

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General NPI Number Information
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    NPI Number           |    1205984747
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    Entity Type          |    Individual 
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    Provider Name        |    NICHOLAS CAMPANELLA DC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/08/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    4A NORTH AVE STE 207
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    City                 |    BEL AIR
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    State                |    MD
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    Zip                  |    21014
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    Country              |    US
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    Telephone            |    410-893-8339
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    Fax                  |    410-838-8011
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Provider Business Mailing Address
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    Address Line         |    4A NORTH AVE STE 207
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    City                 |    BEL AIR
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    State                |    MD
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    Zip                  |    21014
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    Country              |    US
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    Telephone            |    410-893-8339
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    Fax                  |    410-838-8011
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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        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    S01516
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    License Number State |    MD
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