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General NPI Number Information
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NPI Number | 1225052285
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Entity Type | Individual
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Provider Name | ANDREW BRUCE CAMPBELL MD
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 1610 NE 1ST ST APT 10
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City | FORT LAUDERDALE
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State | FL
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Zip | 33301-3800
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Country | US
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Telephone | 954-760-4306
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Fax | 954-760-4306
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Provider Business Mailing Address
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Address Line | 27005 KNICKERBOCKER RD
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City | BAY VILLAGE
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State | OH
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Zip | 44140-2383
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Country | US
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Telephone | 888-365-5514
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Fax | 800-616-0084
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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 | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number | ME97339
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 153691-01
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 25MA08178100
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD044591L
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME97339
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License Number State | FL
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