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NPI 1215482732

NPI 1215482732 : CAROLYN MEDER : CINCINNATI, OH

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General NPI Number Information
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    NPI Number           |    1215482732
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    Entity Type          |    Individual 
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    Provider Name        |    CAROLYN MEDER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/25/2016
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    Last Update Date     |    01/25/2019
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Provider Practice Location Address
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    Address Line         |    1555 CENTRAL PKWY MERCY HEALTH
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    City                 |    CINCINNATI
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    State                |    OH
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    Zip                  |    45214
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    Country              |    US
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    Telephone            |    412-977-0121
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6693 KINSMAN RD 
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    City                 |    PITTSBURGH
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    State                |    PA
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    Zip                  |    15217-1359
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    Country              |    US
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    Telephone            |    412-977-0121
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    
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    License Number State |    
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