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NPI 1225456494

NPI 1225456494 : MAJDI MOJAHED CCP : YOUNGSTOWN, OH

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General NPI Number Information
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    NPI Number           |    1225456494
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    Entity Type          |    Individual 
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    Provider Name        |    MAJDI MOJAHED CCP
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/03/2014
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    Last Update Date     |    04/03/2014
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Provider Practice Location Address
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    Address Line         |    1386 POWERSDALE AVE 
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    City                 |    YOUNGSTOWN
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    State                |    OH
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    Zip                  |    44502-2154
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    Country              |    US
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    Telephone            |    330-559-3968
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1386 POWERSDALE AVE 
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    City                 |    YOUNGSTOWN
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    State                |    OH
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    Zip                  |    44502-2154
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    Country              |    US
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    Telephone            |    330-559-3968
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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        |    242T00000X
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    Taxonomy Name        |    Perfusionist
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    License Number       |    129111
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    License Number State |    CA
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