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General NPI Number Information
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NPI Number | 1235362831
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Entity Type | Organization
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Legal Business Name | CARE IMAGING AND DIAGNOSIS LIMITED
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Dates
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Enumeration Date | 08/29/2009
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Last Update Date | 08/29/2009
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Provider Practice Location Address
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Address Line | 15118 E CAMELVIEW DR
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-6405
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Country | US
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Telephone | 480-606-8690
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Fax |
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Provider Business Mailing Address
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Address Line | 15118 E CAMELVIEW DR
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City | FOUNTAIN HILLS
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State | AZ
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Zip | 85268-6405
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Country | US
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Telephone | 480-606-8690
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DHARMENDRA GUDIMETLA
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Credential |
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Telephone | 480-606-8690
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | N-1548883-0
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License Number State | AZ
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