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General NPI Number Information
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NPI Number | 1215371760
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Entity Type | Individual
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Provider Name | ANUSHA SHIRWAIKAR THOMAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | 6565 FANNIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-2703
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Country | US
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Telephone | 713-441-5114
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Fax | 713-790-6615
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Provider Business Mailing Address
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Address Line | 1757 MANOR BROOK WAY
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City | SNELLVILLE
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State | GA
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Zip | 30078-3061
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Country | US
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Telephone | 770-910-2414
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 574226
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License Number State | TX
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