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General NPI Number Information
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NPI Number | 1215750161
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Entity Type | Individual
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Provider Name | ATUL KUMAR MD,PHD
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 11555 CENTRAL PKWY STE 903
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City | JACKSONVILLE
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State | FL
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Zip | 32224-2701
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Country | US
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Telephone | 863-874-0898
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Fax | 833-728-7333
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Provider Business Mailing Address
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Address Line | 10613 MIDLAND MANOR CT
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City | SAINT LOUIS
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State | MO
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Zip | 63114-1202
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Country | US
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Telephone | 314-745-3028
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | HSE41399
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License Number State | FL
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